Provider Demographics
NPI:1073011862
Name:ASY, AHMED (PT)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ASY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 VILLAGE CENTER DR STE 205
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-4526
Mailing Address - Country:US
Mailing Address - Phone:630-920-4670
Mailing Address - Fax:
Practice Address - Street 1:4455 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-4708
Practice Address - Country:US
Practice Address - Phone:630-575-6250
Practice Address - Fax:630-575-7450
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist