Provider Demographics
NPI:1518223692
Name:THINFAST MD LLC
Entity Type:Organization
Organization Name:THINFAST MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-777-8067
Mailing Address - Street 1:135 E ALGONQUIN RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5321
Mailing Address - Country:US
Mailing Address - Phone:224-777-8067
Mailing Address - Fax:
Practice Address - Street 1:135 E ALGONQUIN RD STE A2
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-5321
Practice Address - Country:US
Practice Address - Phone:224-777-8067
Practice Address - Fax:224-236-4900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007392207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-126253Medicaid