MEDICARE: DR. MOHAMMED I. AHMED 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
1	208D00000X	General Practice Physician	036081126	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0031604609	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427035500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED I. AHMED M.D.

Provider Business Mailing Address
First Line	:	737 S FAIRFIELD AVE
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-3503
Country	:	US
Telephone Number	:	630-627-7909
Fax Number	:	773-533-1479

Provider Business Practice Location Address
First Line	:	2803 W HARRISON ST
Second Line	:	HARRISON MEDICAL CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60612-3332
Country	:	US
Telephone Number	:	773-533-5523
Fax Number	:	773-533-1479

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	03/11/2024

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