Makin Uddin Ahmed, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Practice address

415 W Main St
Ste # 1
Collinsville, IL 62234

Phone

(618) 346-2241

Fax

(618) 346-4013

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821134495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W MAIN ST",
            "address_2": "STE # 1",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "62234",
            "telephone_number": "618-346-2241",
            "fax_number": "618-346-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W MAIN ST",
            "address_2": "STE # 1",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "62234",
            "telephone_number": "618-346-2241",
            "fax_number": "618-346-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MAKIN",
        "middle_name": "UDDIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Collinsville, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.