Basic Information
Provider Information
NPI: 1407298334
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMED
FirstName: ASRAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1860 PAYSPHERE CIR
Address2:  
City: CHICAGO
State: IL
PostalCode: 606740018
CountryCode: US
TelephoneNumber: 6304699200
FaxNumber:  
Practice Location
Address1: 133 E BRUSH HILL RD STE 110
Address2:  
City: ELMHURST
State: IL
PostalCode: 601265659
CountryCode: US
TelephoneNumber: 6306274722
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2013
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125062899ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X108919MNN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X036-151773ILY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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