Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 36243 | IA |
Y | 207VX0201X | Gynecologic Oncologist | 036119719 | IL |
N | 207VX0201X | Gynecologic Oncologist | 36243 | IA |
NPI | 1154372068 |
---|---|
Provider Name | Dr. Amina Ahmed |
First Address | Chicago, IL 60611-2914 |
Second Address | Chicago, IL 60611-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0488460 | (05) | IA |
12164 | WELLMARK BCBS (01) | IA |
I51835 | (02) |