Healthcare Provider Details

I. General information

NPI: 1205156940
Provider Name (Legal Business Name): ASLAM AHMED MOHAMMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E. ORANGE ST
HOOPESTON IL
60942
US

IV. Provider business mailing address

12420 MILESTONE CENTER DR STE 200
GERMANTOWN MD
20876-7111
US

V. Phone/Fax

Practice location:
  • Phone: 217-283-5644
  • Fax: 217-283-7432
Mailing address:
  • Phone: 240-686-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD36778
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.36678
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.131274
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.131274
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number036.131274
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.36778
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: