Kirun Naseem Ahmad, D.O.

Individual provider Active NPI Internal Medicine Physician · Marion, IL

NPI 1992966873 · NPPES record last updated Dec 10, 2012

Key facts

NPI
1992966873
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
036127976 (IL)
Practice address
2401 West Main Street
Marion, IL 62959-1496
Phone
(618) 246-2910
Fax
(618) 246-2912
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

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 IDStateProvider typePAC IDDetails
I20150123001796 IL Order and Referring Only - General Practice
Practitioner - General Practice
8224352182

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036127976ILMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036127976 IL Yes

Addresses

Primary practice location

2401 West Main Street
Marion, IL 62959-1496

Mailing address

2401 W Main St
Marion, IL 62959-1188
Phone (618) 246-2910

Other providers in Marion, IL

All providers in Marion, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.