Provider Demographics
NPI:1225491095
Name:AHSAN, MUHAMMAD (DO)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:AHSAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N WOOD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6557
Mailing Address - Country:US
Mailing Address - Phone:810-423-3441
Mailing Address - Fax:
Practice Address - Street 1:820 N WOOD ST APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-6557
Practice Address - Country:US
Practice Address - Phone:810-423-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.151586208M00000X
MELT19008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist