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General NPI Number Information
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NPI Number | 1720228752
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Entity Type | Organization
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Legal Business Name | AHMED FARAG MD PC
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 60 E DELAWARE PL SUITE 1410
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City | CHICAGO
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State | IL
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Zip | 60611-6559
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Country | US
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Telephone | 312-867-9000
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Fax | 312-867-9127
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Provider Business Mailing Address
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Address Line | 60 E DELAWARE PL SUITE 1410
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City | CHICAGO
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State | IL
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Zip | 60611-6559
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Country | US
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Telephone | 312-867-9000
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Fax | 312-867-9127
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AHMED FARAG
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Credential | MD
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Telephone | 847-830-3841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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