MEDICARE: AFIA AHMED

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
1	363LF0000X	Family Nurse Practitioner	209.019994	IL

General Provider Information

NPI Number	:	1720624141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFIA AHMED

Provider Business Mailing Address
First Line	:	2254 W ADAMS ST APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2254 W ADAMS ST APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2049
Country	:	US
Telephone Number	:	630-803-0215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2019
Last Update Date	:	11/20/2019

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Directions to “ AFIA AHMED ” Practice Location

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