Provider Demographics
NPI:1356374292
Name:AHMED, K. BASHEER (BS, RRT, CRTT, CPFT)
Entity type:Individual
Prefix:MR
First Name:K. BASHEER
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:BS, RRT, CRTT, CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 E IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1679
Mailing Address - Country:US
Mailing Address - Phone:847-877-1601
Mailing Address - Fax:630-422-7186
Practice Address - Street 1:346 E IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1679
Practice Address - Country:US
Practice Address - Phone:847-877-1601
Practice Address - Fax:630-422-7186
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000540332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363561463001Medicaid
IL0215410001Medicare ID - Type Unspecified