Provider Demographics
NPI:1639278138
Name:AHMED, SYED SOHAIL (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:SOHAIL
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:S.
Other - Middle Name:SOHAIL
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2315 EAST 93RD STREET
Mailing Address - Street 2:SUITE 336
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617
Mailing Address - Country:US
Mailing Address - Phone:773-768-6400
Mailing Address - Fax:773-768-6373
Practice Address - Street 1:5500 HOHMAN AVENUE
Practice Address - Street 2:SUITE 1E
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320
Practice Address - Country:US
Practice Address - Phone:219-853-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360872952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG20380Medicare UPIN