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General NPI Number Information
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NPI Number | 1801805148
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Entity Type | Individual
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Provider Name | AHMED MOHAMED R.P.T, MS
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 6060 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2778
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Country | US
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Telephone | 708-952-1052
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Fax | 708-952-1053
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Provider Business Mailing Address
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Address Line | 10448 S PULASKI RD SUITE 4&5
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City | OAK LAWN
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State | IL
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Zip | 60453-4895
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Country | US
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Telephone | 708-952-1052
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Fax | 708-952-1053
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070-009262
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License Number State | IL
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