Provider Demographics
NPI:1902164437
Name:AHMED, NIDA
Entity Type:Individual
Prefix:
First Name:NIDA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 7100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2379
Mailing Address - Country:US
Mailing Address - Phone:847-618-3800
Mailing Address - Fax:847-618-3809
Practice Address - Street 1:880 W CENTRAL RD STE 7100
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2379
Practice Address - Country:US
Practice Address - Phone:847-618-3800
Practice Address - Fax:847-618-3809
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361443432086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036144343OtherSTATE LICENSE