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General NPI Number Information
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NPI Number | 1932089950
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Entity Type | Individual
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Provider Name | MAHMOUD AHMED DPT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 60 E DELAWARE PL STE 1460
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City | CHICAGO
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State | IL
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Zip | 60611-1806
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Country | US
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Telephone | 312-642-3963
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Fax | 312-642-3966
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Provider Business Mailing Address
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Address Line | PO BOX 228
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-0228
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Country | US
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Telephone | 630-300-3770
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Fax | 630-300-3820
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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 | 070.029440
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License Number State | IL
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