Individual
AHMAD MOHAMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
350 W CARPENTER ST, SPRINGFIELD, IL 62702-4902
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.060233
IL
207R00000X
Internal Medicine Physician
2020020200
MO
207RN0300X
Nephrology Physician
Primary
036160127
IL
Other
Enumeration date
11/01/2011
Last updated
10/03/2022
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