Imani Alima Ibrahim

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61375018 Issued in WA

Practice address

5113 S Harper Ave # 2079
Chicago, IL 60615-4119

Phone

(708) 803-2899

NPI assigned

May 16, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Your Therapy S.P.a.C.E. LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1265131262
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1023545464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2079",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "708-803-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2079",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "708-803-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "IMANI ALIMA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61375018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fazeelah Ibrahim, MD
• Filsan Ibrahim
• Gamal Riad Ibrahim, PHYSICAL THERAPIST
• Hena Y Ibrahim, M.D
• Ibukunoluwa Ibrahim
• Ishaq Ibrahim
• Israh Ibrahim
• Khalil Ibrahim, M.D.
• Manal Ibrahim, DMD
• Mohamed Attia Ibrahim, PT, DSC, MS, NCS

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.