Individual
DR. MANSOOR AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 DEKALB AVE, HOUSE STAFF ADMINISTRATION, BROOKLYN, NY 11201-5425
(718) 250-8000
Mailing address
404 WOODSIDE DR, WOOD DALE, IL 60191-2535
(630) 822-2445
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005836
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2016
Last updated
08/29/2019
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