Provider Demographics
NPI:1124051339
Name:AHOMKA-LINDSAY, DINAH (MD)
Entity type:Individual
Prefix:DR
First Name:DINAH
Middle Name:
Last Name:AHOMKA-LINDSAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W 111TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-1851
Mailing Address - Country:US
Mailing Address - Phone:708-660-3200
Mailing Address - Fax:708-923-9818
Practice Address - Street 1:7000 W 111TH ST STE 210
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-1851
Practice Address - Country:US
Practice Address - Phone:708-660-3200
Practice Address - Fax:708-923-9818
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03689993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03689993OtherSTATE LICENSE