| Ahmed Shafi P C | |
|
9101 Devon Ridge Dr Burr Ridge IL 60527-8368 | |
| (630) 887-0641 | |
| (866) 261-3402 |
| Full Name | Ahmed Shafi P C |
|---|---|
| Speciality | Family Medicine |
| Location | 9101 Devon Ridge Dr, Burr Ridge, Illinois |
| Authorized Official Name and Position | Ahmed Shafi (PHYSICIAN) |
| Authorized Official Contact | 6308870641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahmed Shafi P C 9101 Devon Ridge Dr Burr Ridge IL 60527-8368 Ph: (630) 887-0641 | Ahmed Shafi P C 9101 Devon Ridge Dr Burr Ridge IL 60527-8368 Ph: (630) 887-0641 |
| NPI Number | 1043473747 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 07/03/2008 |
| Medicare PECOS PAC ID | 9931250388 |
|---|---|
| Medicare Enrollment ID | O20090625000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043473747 | NPI | - | NPPES |
| 1912997743 | Other | IL | NPI |
| 036098168 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036098168 (Illinois) | Primary |
| Provider Name | Ahmed Shafi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912997743 PECOS PAC ID: 9739131582 Enrollment ID: I20050221000207 |
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