MAQBOOL AHMAD NPI 1033355631

NPI Information

NPI: 1033355631
Provider Name: MAQBOOL AHMAD
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
Doing Business As: MARION EYE SURGERY CENTER, L.L.C.
CLIA Number: 26D2152888
Address: 2900 BROADWAY ST
SUITE B
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 993-5686

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NPI Details

MAQBOOL AHMAD is an ambulatory surgical clinic center in Mount Vernon, IL. MAQBOOL AHMAD NPI is 1033355631. The provider is registered as an organization entity type.
The provider Is Doing Business As Marion Eye Surgery Center, L.l.c..

The provider's business location address is:

2900 BROADWAY ST
SUITE B
MOUNT VERNON, IL
ZIP 62864-341
Phone: (618) 993-5686
Fax: (618) 997-6250

The provider's authorized official is Maqbool Ahmad .
The authorized official title is Owner and has the following contact phone number (618) 993-5686.

The CLIA number assigned to this NPI record is 26D2152888 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2009 and was last updated on 4/29/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	036051996	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========001	MEDICAID	ILLINOIS
2	A03147	OTHER	ILLINOIS	HEALTHLINK
3	P00802628	OTHER	ILLINOIS	MEDICARE RAILROAD
4	IL3063	MEDICARE PIN	ILLINOIS
5	51524	OTHER	ILLINOIS	BCBS OF ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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