Active NPI
Rizwan S Ahmad, M.D.
- Surgery Physician
- Streator, IL
National Provider Identifier
1578710562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036124179
- Practice address
- 104 W 6TH St
Suite 204
Streator, IL 61364-2899 - Phone
- (815) 673-5533
- Fax
- (815) 673-2554
- NPI assigned
- Aug 21, 2008
- Last updated
- Aug 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036124179 | IL | Primary |
| Colon & Rectal Surgery Physician | 208C00000X | 036124179 | IL |
Addresses
Primary practice location
104 W 6TH St
Suite 204
Streator, IL 61364-2899
Mailing address
104 W 6TH St
Suite 204
Streator, IL 61364-2899
Phone (815) 673-5533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD28493 | Other | OR | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036124179 | IL | MD | Colon & Rectal Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Past | Accepting new patients | |
| HSHS Medical Group Inc | Past | Accepting new patients | |
| Caner Celeboglu MD SC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Streator, IL
- NPI 1669680112
-
dba HSHS Medical Group Family Medicine - Dieterich
- Rural Health Clinic/Center
- Dieterich, IL
- NPI 1033841192
-
- Durable Medical Equipment & Medical Supplies
- Jacksonville, IL
- NPI 1629465414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313971200000",
"number": "1578710562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W 6TH ST",
"address_2": "SUITE 204",
"city": "STREATOR",
"state": "IL",
"postal_code": "613642899",
"telephone_number": "815-673-5533",
"fax_number": "815-673-2554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W 6TH ST",
"address_2": "SUITE 204",
"city": "STREATOR",
"state": "IL",
"postal_code": "613642899",
"telephone_number": "815-673-5533",
"fax_number": "815-673-2554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMAD",
"first_name": "RIZWAN",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-21",
"last_updated": "2011-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036124179",
"primary": true
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "IL",
"license": "036124179",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "MD28493",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Streator, IL
- A K Roy MD SC
- Mohamad Abdul-Maboud
- Accelerated Rehabilitation Centers, LTD (Athletico Physical Therapy)
- Advanced Medical Therapy LLC
- Maria Imailin Aala Aguilar
- Ashley Ainsley
- Anesthesia Associates of Streator SC
- Anesthesia Pain Services LLC
- Arc at Streator LLC (Arc at Streator)
- Arc at Streator LLC (Arc at Streator)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.