Organization
AUGUSTA DAMEN MEDICAL CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAFIA SULTANA AHMED M.D. (FAMILY PRACTICE)
(773) 276-2655
Entity
Organization
Contact information
Practice address
948 N DAMEN AVE, CHICAGO, IL 60622-4910
(773) 276-2655
(773) 276-2726
Mailing address
948 N DAMEN AVE, CHICAGO, IL 60622-4910
(773) 276-2655
(773) 276-2726
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036068577
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068577
—
IL
Enumeration date
04/22/2008
Last updated
10/06/2008
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