Individual
AHMED NAZIMUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6101 S COUNTY LINE RD, BURR RIDGE, IL 60527-8132
(630) 686-9000
(844) 235-2578
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-8132
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036128135
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
036128135
IL
390200000X
Student in an Organized Health Care Education/Training Program
125054244
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125054244
STATE LICENSE
IL
01
—
208341
MEDICARE GROUP PTAN
—
01
—
208342
GROUP PTAN
—
01
—
F100323989
GROUP MEDICARE PTAN
IL
Enumeration date
07/08/2008
Last updated
08/25/2023
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