Individual
MANSOOR AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(872) 200-4430
Mailing address
420 W SURF ST APT 211, CHICAGO, IL 60657-6114
(872) 200-4430
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.084348
IL
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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