Healthcare Provider Details

I. General information

NPI: 1588721328
Provider Name (Legal Business Name): AHMAD ABDUL KARIM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MADISON ST SUITE 207
JOLIET IL
60435-6549
US

IV. Provider business mailing address

301 MADISON ST SUITE 275
JOLIET IL
60435-6549
US

V. Phone/Fax

Practice location:
  • Phone: 815-740-1900
  • Fax: 815-725-2413
Mailing address:
  • Phone: 815-740-1900
  • Fax: 815-725-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number036118387
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: