John Fikry Mityas Ibrahim, M.D

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

01084871A Issued in IN

Practice address

11S513 Rachael CT
Willowbrook, IL 60527-6899

Phone

(331) 214-1843

NPI assigned

Aug 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN, WI, FL4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cep America-Illinois Hospitalists, LLPGroup PAC ID 3274765904, 193 clinicians

Inpatient Consultants of Illinois, P.C.Group PAC ID 9537064316, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1841613403
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Illinois, P.C.

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1548442569

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Jme Medical Services

  • Internal Medicine Physician
  • Burr Ridge, IL
  • NPI 1568036879
  Medicare reassignment NPD Authorized official
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Internal Medicine

  Medicare reassignment NPD
• Miinedoctor, Inc.

  • Internal Medicine Physician
  • Crestwood, IL
  • NPI 1144795279
  Medicare reassignment NPD
• Osf Healthcare System

  • Certified Registered Nurse Anesthetist
  • Monmouth, IL
  • NPI 1811016124
  Medicare reassignment NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1205614336
  Medicare reassignment NPD
• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1871178368

  Internal Medicine

  Medicare reassignment NPD
• Vituity-Wisconsin HM SC

  • Hospitalist Physician
  • Pleasant Prairie, WI
  • NPI 1679265912
  Medicare reassignment NPD
• Cep America-Illinois Hospitalists

  • Hospitalist Physician
  • Bloomington, IL
  • NPI 1669276523
  NPD
• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Litchfield, IL
  • NPI 1336916808
  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba OSF Little Company of Mary Medical Center

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045
  Care Compare affiliation
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Women's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1134675218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11S513 RACHAEL CT",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605276899",
            "telephone_number": "331-214-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11S513 RACHAEL CT",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605276899",
            "telephone_number": "331-214-1843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20201 Crawford Ave",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "844-740-4445",
            "fax_number": "708-679-2161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JOHN",
        "middle_name": "FIKRY MITYAS",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125069705",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036147616",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "1018-320",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036147616",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME151077",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01084871A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hong, PT
• Larry Hopkins, D.C.
• Anthony Richard Hormanski, DDS
• Shannon Houda
• Michelle Marie Huang, OTRL
• Sandy E Ied, MBA
• Il Diagnostics Corporation
• Illinois Bone and Joint Institute LLC
• Institute for Health Behavior Change Inc.
• Integrated Health Care Services, Inc

• Hospitalist Physician in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.