Individual
FAZAL AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 W HARRISON ST, ROOM # 3022, CHICAGO, IL 60612-3714
(312) 864-6007
(312) 864-9371
Mailing address
1901 W HARRISON ST, ROOM # 3022, CHICAGO, IL 60612-3714
(312) 864-6007
(312) 864-9371
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2084P0800X
Psychiatry Physician
036-107430
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036-107430
IL
Other
Enumeration date
08/31/2006
Last updated
04/21/2021
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