Provider Demographics
NPI:1003234592
Name:UDDIN, AHMED MOYUKH
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:MOYUKH
Last Name:UDDIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:MESKATHUL
Other - Last Name:MAMTAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPT. OF ANESTHESIOLOGY, ADVOCATE CHRIST MEDICAL CENTER
Mailing Address - Street 2:4440 W 95TH ST
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:612-308-4820
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF ANESTHESIA, ADVOCATE CHRIST MEDICAL CENTER
Practice Address - Street 2:4440 W 95TH ST
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:612-308-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036141775207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology