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NPI Code Detail

MEDICARE: DR. DINAH AHOMKA-LINDSAY M.D.

MEDICARE: DR. DINAH AHOMKA-LINDSAY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician03689993IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103689993OTHERILSTATE LICENSE

General Provider Information

NPI Number : 1124051339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DINAH AHOMKA-LINDSAY M.D.
Provider Business Mailing Address
First Line : 7000 W 111TH ST STE 210
Second Line :
City : WORTH
State : IL
Zip : 60482-1851
Country : US
Telephone Number : 708-660-3200
Fax Number : 708-923-9818
Provider Business Practice Location Address
First Line : 7000 W 111TH ST STE 210
Second Line :
City : WORTH
State : IL
Zip : 60482-1851
Country : US
Telephone Number : 708-660-3200
Fax Number : 708-923-9818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 07/08/2007

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