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General NPI Number Information
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NPI Number | 1669268777
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Entity Type | Individual
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Provider Name | SAFA AHMED DO
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Gender | Female
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Dates
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Enumeration Date | 04/16/2025
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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 JAVON BEA HOSPITAL 8201 EAST RIVERSIDE BOULEVARD
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City | ROCKFORD
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State | IL
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Zip | 61114
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Country | US
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Telephone | 815-971-7000
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Fax |
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Provider Business Mailing 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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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125.086269
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License Number State | IL
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