Individual
MR. IJAZ AHMAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9133 S STONY ISLAND AVE, CHICAGO, IL 60617-3512
(773) 375-3312
(773) 375-2334
Mailing address
9133 S STONY ISLAND AVE, CHICAGO, IL 60617-3512
(773) 375-3312
(773) 375-2334
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036107581
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-107581
LIC PHY
IL
05
—
036107581
—
IL
Enumeration date
01/29/2007
Last updated
02/02/2022
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