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NPI Code Detail

MEDICARE: DR. ILYAS AHMED PHARMD

MEDICARE:  DR. ILYAS  AHMED  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051038329IL

General Provider Information

NPI Number : 1235411497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ILYAS AHMED PHARMD
Provider Business Mailing Address
First Line : 3019 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3726
Country : US
Telephone Number : 773-728-6254
Fax Number :
Provider Business Practice Location Address
First Line : 3019 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3726
Country : US
Telephone Number : 773-728-6254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 09/14/2011

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Directions to “ DR. ILYAS AHMED PHARMD” Practice Location

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