Provider Demographics
NPI:1134015589
Name:AHMED, JAVEREA (DO)
Entity type:Individual
Prefix:
First Name:JAVEREA
Middle Name:
Last Name:AHMED
Suffix:
Gender:X
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 JACKSON LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1407
Mailing Address - Country:US
Mailing Address - Phone:630-542-3536
Mailing Address - Fax:
Practice Address - Street 1:700 MULLICA HILL RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-4413
Practice Address - Country:US
Practice Address - Phone:630-542-5366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program