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Individual

AFSHAN HAFIZ AHMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
(708) 245-5614
Mailing address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
(708) 245-5614

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036104408
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
036104408
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036-104408
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036104408
IL
01
208342
GROUP PTAN
01
P00722359
RAILROAD MEDICARE
IL
Enumeration date
12/11/2006
Last updated
03/17/2015
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