Provider Demographics
NPI:1972667129
Name:AHMED, HUMA A (CSA)
Entity Type:Individual
Prefix:
First Name:HUMA
Middle Name:A
Last Name:AHMED
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10001 W ROOSEVELT RD
Mailing Address - Street 2:SUITE #304
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2664
Mailing Address - Country:US
Mailing Address - Phone:708-345-4464
Mailing Address - Fax:708-344-6577
Practice Address - Street 1:10001 W ROOSEVELT RD
Practice Address - Street 2:SUITE #304
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2664
Practice Address - Country:US
Practice Address - Phone:708-345-4464
Practice Address - Fax:708-344-6577
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist