Provider Demographics
NPI:1326201666
Name:FAROOQ, AHMER V (DO)
Entity Type:Individual
Prefix:DR
First Name:AHMER
Middle Name:V
Last Name:FAROOQ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:DEPARTMENT OF UROLOGY, FAHEY CENTER RM 239A
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-5100
Mailing Address - Fax:708-216-8991
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:DEPARTMENT OF UROLOGY, FAHEY CENTER RM 260
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-5100
Practice Address - Fax:708-216-8991
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2021-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036122015208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology