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204 E Prairie St Marengo IL 60152-3107 | |
(779) 696-9553 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 204 E Prairie St, Marengo, Illinois |
Authorized Official Name and Position | Don Daniels (VP) |
Authorized Official Contact | 8159662084 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1567 Rockford IL 61110-0067 Ph: (779) 696-7150 | 204 E Prairie St Marengo IL 60152-3107 Ph: (779) 696-9553 |
NPI Number | 1366769218 |
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Provider Enumeration Date | 04/30/2010 |
Last Update Date | 07/30/2013 |
Identifier | Type | State | Issuer |
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1366769218 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
T Ahmad Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 21807 W Grant Hwy, Marengo, IL 60152 Phone: 815-568-1074 Fax: 815-568-0134 |