Provider Demographics
NPI:1700992799
Name:AMER, EMAD MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:MOHAMMED
Last Name:AMER
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 1:69 SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5823
Mailing Address - Country:US
Mailing Address - Phone:630-351-1770
Mailing Address - Fax:630-858-0405
Practice Address - Street 1:121 FAIRFIELD WAY
Practice Address - Street 2:SUITE 240
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1588
Practice Address - Country:US
Practice Address - Phone:630-351-1770
Practice Address - Fax:630-858-1662
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360946582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094Medicaid
IL036094Medicaid