MEDICARE: AMBEREEN GHANI 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	207Q00000X	Family Medicine Physician	036116124	IL

General Provider Information

NPI Number	:	1548468127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBEREEN GHANI M.D.

Provider Business Mailing Address
First Line	:	2500 W HIGGINS RD
Second Line	:	STE 400
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-2044
Country	:	US
Telephone Number	:	847-490-6817
Fax Number	:	847-490-6819

Provider Business Practice Location Address
First Line	:	959 WEST GOLF ROAD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-1329
Country	:	US
Telephone Number	:	847-490-6817
Fax Number	:	847-490-6819

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	10/20/2021

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