Provider Demographics
NPI:1629497045
Name:AHSAN, ZAHAB SHAHID (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAHAB
Middle Name:SHAHID
Last Name:AHSAN
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 1:1331 W 75TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9311
Mailing Address - Country:US
Mailing Address - Phone:630-646-7000
Mailing Address - Fax:
Practice Address - Street 1:1331 W 75TH ST STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9311
Practice Address - Country:US
Practice Address - Phone:630-646-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0412249207XX0005X
390200000X
IL036.153184207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program