Healthcare Provider Details

I. General information

NPI: 1255592655
Provider Name (Legal Business Name): SAUD SUHAEL AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 W 95TH ST STE 203
EVERGREEN PARK IL
60805-2734
US

IV. Provider business mailing address

2850 W 95TH ST STE 203
EVERGREEN PARK IL
60805-2734
US

V. Phone/Fax

Practice location:
  • Phone: 708-229-4050
  • Fax: 708-229-4051
Mailing address:
  • Phone: 708-229-4050
  • Fax: 708-229-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036136518
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: