Healthcare Provider Details

I. General information

NPI: 1144637380
Provider Name (Legal Business Name): CHAUDHARY FAIZAN AHMED M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S FAIRFIELD AVE
CHICAGO IL
60608-1782
US

IV. Provider business mailing address

856 W NELSON ST APT 1206
CHICAGO IL
60657-9202
US

V. Phone/Fax

Practice location:
  • Phone: 773-542-2000
  • Fax:
Mailing address:
  • Phone: 872-305-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036149792
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.149792
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number036.149792
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: