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General NPI Number Information
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NPI Number | 1629838693
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Entity Type | Individual
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Provider Name | AWAIS AHMED MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | MERCYHEALTH ALPINE CLINIC 7702 N. ALPINE RD
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City | LOVES PARK
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State | IL
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Zip | 61111
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Country | US
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Telephone | 815-971-2000
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Fax |
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Provider Business Mailing Address
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Address Line | MERCYHEALTH ALPINE CLINIC 7702 NORTH ALPINE ROAD
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City | LOVES PARK
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State | IL
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Zip | 61111
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Country | US
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Telephone | 158-971-2000
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125.084494
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License Number State | IL
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