| T Ahmad Md Sc | |
|
21807 W Grant Hwy Marengo IL 60152-2944 | |
| (815) 568-1074 | |
| (815) 568-0134 |
| Full Name | T Ahmad Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21807 W Grant Hwy, Marengo, Illinois |
| Authorized Official Name and Position | Tanveer Ahmad (OWNER) |
| Authorized Official Contact | 8157039124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| T Ahmad Md Sc Po Box 1527 Woodstock IL 60098-1527 Ph: (847) 338-1477 | T Ahmad Md Sc 21807 W Grant Hwy Marengo IL 60152-2944 Ph: (815) 568-1074 |
| NPI Number | 1790078111 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 12/14/2011 |
| Medicare PECOS PAC ID | 5294906624 |
|---|---|
| Medicare Enrollment ID | O20110915000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790078111 | NPI | - | NPPES |
| 036072630 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036072630 (Illinois) | Primary |
| Provider Name | Tanveer Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093811374 PECOS PAC ID: 5395646640 Enrollment ID: I20040119000623 |
Osfmg - Marengo Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 556 E Grant Hwy, Marengo, IL 60152 Phone: 800-589-6070 Fax: 309-683-5969 | |
Samg Marengo Immediate Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 E Prairie St, Marengo, IL 60152 Phone: 779-696-9553 | |
Samg Marengo Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 E Prairie St, Marengo, IL 60152 Phone: 779-696-9553 |