Provider Demographics
NPI:1679351092
Name:ABDELGHANI, AHMAD Y (PA-C)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:Y
Last Name:ABDELGHANI
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 WILEY RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4356
Mailing Address - Country:US
Mailing Address - Phone:847-490-0060
Mailing Address - Fax:630-931-3330
Practice Address - Street 1:1365 WILEY RD STE 149
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4357
Practice Address - Country:US
Practice Address - Phone:847-490-0060
Practice Address - Fax:630-931-3330
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7630-23207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine