Provider Demographics
NPI:1871606731
Name:AHMED, BASHEER (MD)
Entity type:Individual
Prefix:
First Name:BASHEER
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:1315 LEHMEN DRIVE
Mailing Address - City:CHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:62233-0031
Mailing Address - Country:US
Mailing Address - Phone:618-826-4571
Mailing Address - Fax:618-826-3229
Practice Address - Street 1:1315 LEHMEN DRIVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:IL
Practice Address - Zip Code:62233-0031
Practice Address - Country:US
Practice Address - Phone:618-826-4571
Practice Address - Fax:618-826-3229
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH49213Medicare UPIN
INH49213Medicare UPIN