| Misbah Uddin Ahmed Md Sc | |
|
555 W Court St Ste 200 Kankakee IL 60901-3664 | |
| (815) 935-2525 | |
| (815) 935-1010 |
| Full Name | Misbah Uddin Ahmed Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 555 W Court St, Kankakee, Illinois |
| Authorized Official Name and Position | Misbah Uddin Ahmed (OWNER) |
| Authorized Official Contact | 8159352525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Misbah Uddin Ahmed Md Sc 555 W Court St Ste 200 Kankakee IL 60901-3674 Ph: (815) 935-2525 | Misbah Uddin Ahmed Md Sc 555 W Court St Ste 200 Kankakee IL 60901-3664 Ph: (815) 935-2525 |
| NPI Number | 1114127800 |
|---|---|
| Provider Enumeration Date | 07/20/2007 |
| Last Update Date | 07/08/2008 |
| Medicare PECOS PAC ID | 5092841064 |
|---|---|
| Medicare Enrollment ID | O20100329000911 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114127800 | NPI | - | NPPES |
| 1306854203 | Other | IL | INDIVIDUAL NPI |
| 036205509 | Medicaid | IL | |
| CG4030 | Other | IL | RAILROAD MEDICARE GROUP |
| 110197518 | Other | IL | RAILROAD MEDICARE |
| 036098582 | Medicaid | IL | |
| 1922117811 | Other | IL | INDIVIDUAL NPI |
| 930068554 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Misbah U Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922117811 PECOS PAC ID: 2466588421 Enrollment ID: I20100329000903 |
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