Provider Demographics
NPI:1760502306
Name:RAHMAN, AMERA MANZOOR (MD)
Entity Type:Individual
Prefix:DR
First Name:AMERA
Middle Name:MANZOOR
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 WESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1037
Mailing Address - Country:US
Mailing Address - Phone:626-616-1894
Mailing Address - Fax:626-410-6700
Practice Address - Street 1:200 S GREENLEAF ST
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3398
Practice Address - Country:US
Practice Address - Phone:847-244-5660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228403283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital