Provider Demographics
NPI:1760580344
Name:KHURSHEED AHMED, MD, S.C.
Entity Type:Organization
Organization Name:KHURSHEED AHMED, MD, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURSHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-783-4800
Mailing Address - Street 1:33 W HIGGINS RD STE 5100
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9115
Mailing Address - Country:US
Mailing Address - Phone:847-783-4800
Mailing Address - Fax:847-783-4997
Practice Address - Street 1:33 W HIGGINS RD STE 5100
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9115
Practice Address - Country:US
Practice Address - Phone:847-783-4800
Practice Address - Fax:847-783-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084189OtherSTATE LICENSE
IL036084189OtherSTATE LICENSE
586950Medicare PIN