Provider Demographics
NPI:1275551871
Name:AHMED, MOHAMMED N (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:N
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BAYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1607
Mailing Address - Country:US
Mailing Address - Phone:815-725-1440
Mailing Address - Fax:815-725-1550
Practice Address - Street 1:300 REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6520
Practice Address - Country:US
Practice Address - Phone:815-725-1440
Practice Address - Fax:815-725-1550
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361065682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232165OtherBLUE CROSS BLUE SHIELD
IL036106568Medicaid
IL02232165OtherBLUE CROSS BLUE SHIELD