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General NPI Number Information
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NPI Number | 1033693742
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Entity Type | Individual
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Provider Name | AHMED HUSSAIN MEMON NP
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 3800 W MADISON ST
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City | CHICAGO
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State | IL
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Zip | 60624-2312
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Country | US
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Telephone | 866-267-2353
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Fax | 847-616-5563
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Provider Business Mailing Address
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Address Line | 8427 AUSTIN AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-3213
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Country | US
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Telephone | 224-478-2533
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Fax | 847-616-5563
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.017981
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-017981
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License Number State | IL
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