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General NPI Number Information
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NPI Number | 1831360791
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Entity Type | Organization
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Legal Business Name | AGHA MEDICAL INC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1600 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1902
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Country | US
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Telephone | 815-680-6806
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1902
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Country | US
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Telephone | 815-680-6806
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AHMAD K AGHA
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Credential | M.D
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Telephone | 815-680-6806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036104423
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License Number State | IL
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