MEDICARE: PARVEEN S AHMED DDS

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
1	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1336211689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARVEEN S AHMED DDS

Provider Business Mailing Address
First Line	:	1000 GRAND CANYON PKWY
Second Line	:	209
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60194-1705
Country	:	US
Telephone Number	:	847-310-9816
Fax Number	:	847-310-9817

Provider Business Practice Location Address
First Line	:	1000 GRAND CANYON PKWY
Second Line	:	209
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60194-1705
Country	:	US
Telephone Number	:	847-310-9816
Fax Number	:	847-310-9817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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