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General NPI Number Information
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NPI Number | 1750388476
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Entity Type | Individual
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Provider Name | AHMED ELBORNO MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 6747 KINGERY HWY
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City | WILLOWBROOK
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State | IL
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Zip | 60527-5142
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Country | US
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Telephone | 773-836-7246
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Fax | 773-637-4229
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Provider Business Mailing Address
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Address Line | PO BOX 3336
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City | HINSDALE
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State | IL
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Zip | 60522-3336
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Country | US
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Telephone | 630-245-1010
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Fax | 630-245-1011
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036-095342
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License Number State | IL
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