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Organization

ROSELLE PHYSICAL MEDICINE GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TARIQ AHMED DC (PRESIDENT)
(630) 295-8851
Entity
Organization

Contact information

Practice address
50 E IRVING PARK RD, ROSELLE, IL 60172-2050
(630) 295-8851
(630) 295-8852
Mailing address
50 E IRVING PARK RD, ROSELLE, IL 60172-2050
(630) 295-8851
(630) 295-8852

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
364SA2200X
Adult Health Clinical Nurse Specialist

Other

Enumeration date
07/24/2015
Last updated
07/24/2015
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