MEDICARE: DR. AZIZ UDDIN 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	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1962532044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AZIZ UDDIN AHMED M.D.

Provider Business Mailing Address
First Line	:	1657 W ADAMS ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3201
Country	:	US
Telephone Number	:	630-261-1393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1657 W ADAMS ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3201
Country	:	US
Telephone Number	:	312-829-1134
Fax Number	:	312-829-4602

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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