Healthcare Provider Details

I. General information

NPI: 1750486981
Provider Name (Legal Business Name): AMR N MEGAHED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S MAIN ST
ALGONQUIN IL
60102-2752
US

IV. Provider business mailing address

1701 W WISE RD
SCHAUMBURG IL
60193-3553
US

V. Phone/Fax

Practice location:
  • Phone: 847-854-5900
  • Fax: 847-805-4600
Mailing address:
  • Phone: 847-895-2900
  • Fax: 847-805-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36111256
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: