Individual
DR. AHMED SHAFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4829 S ASHLAND AVE, CHICAGO, IL 60609-4234
(773) 927-2714
(773) 927-2716
Mailing address
1368 LIBERTY ST, MORRIS, IL 60450-1410
(815) 942-8080
(815) 942-0843
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-098168
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03222998
BCBS
IL
05
—
036-098168
—
IL
Enumeration date
10/24/2005
Last updated
11/30/2007
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