Fatima Ahmad, MD
Individual provider Active NPI Anesthesiology Physician · Maywood, IL
NPI 1760453047 · NPPES record last updated Apr 22, 2021
Key facts
- NPI
- 1760453047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 36106108 (IL)
- Practice address
- 2160 S 1St Ave
Maguire Center, RM 1900
Maywood, IL 60153 - Phone
- (708) 216-8563
- Fax
- (708) 216-4948
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050808000158 | IL | Practitioner - Anesthesiology | 6901835297 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36106108 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current |
Accepting new patients | |
| Loyola University Medical Center | Current |
Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Physician Foundation | Past | Accepting new patients |
Locations
420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
2160 S 1st Ave
#101
Maywood, IL 60153
Phone (708) 216-8785
2160 S 1st Ave
Rm 1900
Maywood, IL 60153
Phone (708) 216-8563
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 36106108 | IL | Yes |
Addresses
Primary practice location
2160 S 1St Ave
Maguire Center, RM 1900
Maywood, IL 60153
Mailing address
2160 S 1St Ave
Maguire Center, RM 1900
Maywood, IL 60153
Phone (708) 216-8563
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36106108 | Medicaid | IL | |
| L90724 | Other | IL | MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fahmad11858@direct.luhs.org | Direct | |
| FHIR URL | https://rxhub.luhs.org/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Maywood, IL
- Caroline Agha
- Rekha Agrawal
- Ana Aguilar
- Oswaldo Aguirre
- Chinelo Agwuncha
- Jovanni Donis Ahmad
- Yusuf Ahmad
- Zachery Ahmann
- Afser Ahmed
- Amena Ahmed
All providers in Maywood, IL · Anesthesiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.