Healthcare Provider Details

I. General information

NPI: 1073431987
Provider Name (Legal Business Name): ZOHA AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 W CONGRESS PKWY # 12
CHICAGO IL
60612-3833
US

IV. Provider business mailing address

12000 WINTERBERRY LN
PLAINFIELD IL
60585-5782
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.571360
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: