Provider Demographics
NPI:1851326110
Name:SHEIKH, AMJAD IRMAN (MD)
Entity Type:Individual
Prefix:MR
First Name:AMJAD
Middle Name:IRMAN
Last Name:SHEIKH
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 1:4640 N MARINE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5719
Mailing Address - Country:US
Mailing Address - Phone:773-564-5912
Mailing Address - Fax:773-743-5078
Practice Address - Street 1:4640 N MARINE DR FL8
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5784
Practice Address - Country:US
Practice Address - Phone:773-564-5912
Practice Address - Fax:773-743-5078
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054916207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054916Medicaid
ILD14309Medicare UPIN