Provider Demographics
NPI:1144949678
Name:AHMAD, AHMAD MOHAMMAD (APN - CRNA)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:MOHAMMAD
Last Name:AHMAD
Suffix:
Gender:M
Credentials:APN - CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 W 115TH PL
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-2351
Mailing Address - Country:US
Mailing Address - Phone:708-890-2829
Mailing Address - Fax:
Practice Address - Street 1:155 E BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5658
Practice Address - Country:US
Practice Address - Phone:331-221-3521
Practice Address - Fax:331-221-3827
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.461634163W00000X
IL209030310367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse