Misbah Uddin Ahmed MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MISBAH UDDIN AHMED MD SC

Practice address

555 W Court St
Ste 200
Kankakee, IL 60901-3664

Phone

(815) 935-2525

Fax

(815) 935-1010

NPI assigned

Jul 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Misbah Uddin Ahmed, MD

Title

Owner

Phone

(815) 935-2525

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Khaleelur R Zackariya Sr., MD

  • Addiction Medicine (Internal Medicine) Physician
  • Mishiwaka, IN
  • NPI 1306854203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1114127800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "STE 200",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013674",
            "telephone_number": "815-935-2525",
            "fax_number": "815-935-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "STE 200",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-935-2525",
            "fax_number": "815-935-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISBAH UDDIN AHMED MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MISBAH",
        "authorized_official_middle_name": "UDDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-935-2525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1306854203",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036205509",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CG4030",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110197518",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098582",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1922117811",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930068554",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana M Miller
• Jennifer Lynn Miller, RPH
• Jonathan B Miller, D.O.
• Kyle L Miller, PHARMD
• Holly Joann Milton
• John A Mitchell, MD
• William G Mitsos, DDS
• Patrick Ndibe Mogbo, PHARM.D.
• Moments Hospice of Kankakee LLC
• Adam Joseph Moody, PTA

• Internal Medicine Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.