Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT194990 | PA |
N | 111NI0900X | Internist | MT194990 | PA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036.132788 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036.132788 | IL |
NPI | 1932333473 |
---|---|
Provider Name | Faraz Shafique Ahmad |
First Address | Chicago, IL 60611-2981 |
Second Address | Chicago, IL 60611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 09/08/2018 |