Individual
AHMAD ALWAKKAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2828 N. CAMBRIDGE AVE # 406, CHICAGO, IL 60657
(312) 806-4533
Mailing address
2828 N CAMBRIDGE AVE APT 406, CHICAGO, IL 60657-6051
(312) 806-4533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036131099
IL
208M00000X
Hospitalist Physician
Primary
036131099
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400092164
FPN INDIVIDUAL MEDICARE PTAN
—
Enumeration date
05/31/2013
Last updated
10/30/2020
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