Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 036066117 | IL |
NPI | 1609816875 |
---|---|
Provider Name | Farida Ahmed |
First Address | Lombard, IL 60148-6110 |
Second Address | Chicago, IL 60634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C42100 | (02) | IL |