Healthcare Provider Details

I. General information

NPI: 1770087918
Provider Name (Legal Business Name): AVAIS AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE. DEPARTMENT OF ANESTHOSIOLOGY
EVANSTON IL
60201
US

IV. Provider business mailing address

2650 RIDGE AVE. DEPARTMENT OF ANESTHOSIOLOGY
EVANSTON IL
60201
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2760
  • Fax: 847-570-2921
Mailing address:
  • Phone: 847-570-2760
  • Fax: 847-570-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036153686
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: