Healthcare Provider Details

I. General information

NPI: 1578826939
Provider Name (Legal Business Name): ZOHAIR AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NE GLEN OAK AVE
PEORIA IL
61637-0001
US

IV. Provider business mailing address

220 E ILLINOIS ST APT 2612
CHICAGO IL
60611-4498
US

V. Phone/Fax

Practice location:
  • Phone: 309-655-2730
  • Fax:
Mailing address:
  • Phone: 630-699-9247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125061405
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036138701
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01083881A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01083881A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: