Organization Name: | MOHAMMED AHMED SERVICE CORPORATION |
NPI Number: | 1467765891 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MOHAMMED ISMAIL AHMED (OWNER) |
Mailing Address: | 2803 W Harrison St Chicago |
State: | IL US |
Postal Code: | 606123332 |
Phone Number: | 7735335523 |
Fax Number: | 7735331479 |
NPI Enumeration Date: | 07/14/2010 |
NPI Last Update Date: | 07/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036081126 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |