Provider Demographics
NPI:1811399504
Name:AHMED, ADNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:
Last Name:AHMED
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 1:2900 N LAKE SHORE DR
Mailing Address - Street 2:SUITE NO. 203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5640
Mailing Address - Country:US
Mailing Address - Phone:773-665-6730
Mailing Address - Fax:773-665-3401
Practice Address - Street 1:2900 N LAKE SHORE DR
Practice Address - Street 2:SUITE NO. 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5640
Practice Address - Country:US
Practice Address - Phone:773-665-6730
Practice Address - Fax:773-665-3401
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.141658207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.141658OtherPHYSICIAN IN HOSPITAL
IL125.065028OtherSTUDENT