Provider Demographics
NPI:1396576294
Name:AHMED, EMAN
Entity type:Individual
Prefix:
First Name:EMAN
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9838 S ROBERTS RD APT 3
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1568
Mailing Address - Country:US
Mailing Address - Phone:629-259-1133
Mailing Address - Fax:
Practice Address - Street 1:9838 S ROBERTS RD APT 3
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1568
Practice Address - Country:US
Practice Address - Phone:629-259-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician