Healthcare Provider Details

I. General information

NPI: 1255105375
Provider Name (Legal Business Name): HANNAH AHMAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 LEGACY CIR STE 100
NAPERVILLE IL
60563-1253
US

IV. Provider business mailing address

2550 N HOLLYWOOD WAY STE 301
BURBANK CA
91505-5025
US

V. Phone/Fax

Practice location:
  • Phone: 331-249-6626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242008386
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: