Individual
AZIZ AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9261
(217) 258-2551
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01063683
IN
2085B0100X
Body Imaging Physician
01063683
IN
2085R0202X
Diagnostic Radiology Physician
Primary
036126040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3407012580
CHAMPUS
IN
Enumeration date
08/05/2007
Last updated
07/02/2025
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