MISBAH UDDIN AHMED MD SC (NPI# 1114127800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114127800 |
| Entity Type | Organization |
| Organization Name | MISBAH UDDIN AHMED MD SC |
| Practice Address |
555 W Court St Ste 200 Kankakee IL 60901-3664 |
| Mailing Address |
555 W Court St Ste 200 Kankakee IL 60901-3674 |
| Practice Telephone | 8159352525 |
| Practice Fax Number | 8159351010 |
| Mailing Telephone | 8159352525 |
| Mailing Fax Number | 8159351010 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2008-07-08 |
| Authorized Official Name | DR. MISBAH UDDIN AHMED (OWNER) |
| Authorized Official Telephone | 8159352525 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036098582 | 05 | |
| IL | RAILROAD MEDICARE | 110197518 | 01 |
| IL | INDIVIDUAL NPI | 1306854203 | 01 |
| IL | 036205509 | 05 | |
| IL | RAILROAD MEDICARE | 930068554 | 01 |
| IL | RAILROAD MEDICARE GROUP | CG4030 | 01 |
| IL | INDIVIDUAL NPI | 1922117811 | 01 |
| Street Address |
555 W COURT ST STE 200 |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-3664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003802349 | Martin T Phillips | Internal Medicine | 555 W Court St, Suite 108, Kankakee, IL 60901-3664 | 2005-09-22 |
| 1083972863 | Michel H. Malek, M.d. PC | Non-Pharmacy Dispensing Site | 555 W Court St, Suite 412, Kankakee, IL 60901-3664 | 2012-04-30 |
| 1194035360 | Michel H. Malek, Md Sc | Neurological Surgery | 555 W Court St, Suite 412, Kankakee, IL 60901-3664 | 2010-10-20 |
| 1902112535 | Fabiola Maria Del Carmen Espinoza | Internal Medicine | 555 W Court St, Suite 108, Kankakee, IL 60901-3664 | 2010-08-20 |
| 1053623801 | Community Pain Consultants, Ltd | Specialist | 555 W Court St, Suite 100, Kankakee, IL 60901-3664 | 2010-07-09 |
| 1518296938 | Donald E Krause Dds Ltd | Clinic/Center | 555 W Court St, Suite 102, Kankakee, IL 60901-3664 | 2009-12-14 |
| 1982844684 | Kankakee Pain Surgical Suite, LLC | Clinic/Center | 555 W Court St, Suite 100, Kankakee, IL 60901-3664 | 2009-02-20 |
| 1255578118 | Kankakee Area Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 555 W Court St, Ste 101, Kankakee, IL 60901-3664 | 2009-01-14 |
| 1457519969 | Consultants In Pathology Sc | Pathology | 555 W Court St, Suite 300, Kankakee, IL 60901-3664 | 2008-05-30 |
| 1275731671 | George B Verghese Md Sc | Orthopaedic Surgery | 555 W Court St, Kankakee, IL 60901-3664 | 2007-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528193430 | Internal Medicine Specialists of Kankakee Sc | Internal Medicine | 555 W Court St Ste 400, Kankakee, IL 60901-3675 | 2007-02-22 |
| 1457429359 | Rita Kashinath Pavate | Internal Medicine | 100 East Jeffery St, Kankakee, IL 60901 | 2006-12-01 |
| 1811094550 | Naresh C Chandan | Internal Medicine | 401 N Wall St Ste 102, Kankakee, IL 60901 | 2006-09-17 |
| 1043228158 | Mario Gerard Massullo | Internal Medicine | 1710 W. Court St., Kankakee, IL 60901 | 2006-08-04 |
| 1689622250 | Joseph A Meisenbach | Internal Medicine | 455 W. Court St., Suite 202, Kankakee, IL 60901-3693 | 2006-05-05 |
| 1235103532 | Samuel G Deguzman | Internal Medicine | 450 Kennedy Drive, Suite 5, Kankakee, IL 60901 | 2006-02-14 |
| 1720072143 | Stonewall Mccuiston Jr. | Internal Medicine | 375 N Wall St Ste P310, Kankakee, IL 60901-3484 | 2005-08-31 |
| 1629693726 | Stephen Tulley | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1891310991 | Matthew Sutherland | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1346863321 | Ahmed Ismail | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-25 |
| Find all providers in KANKAKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.