Mohamed Attia Ibrahim, PT, DSC, MS, NCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070007653 Issued in IL

Practice address

1925 E 95TH St
Chicago, IL 60617-4710

Phone

(312) 929-2950

Fax

(312) 224-4777

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Rehab Team. Inc

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1982879847

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Rehab R US PT PC

  • Physical Therapy Clinic/Center
  • Brooklyn, NY
  • NPI 1326180563
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1639155807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604820488",
            "telephone_number": "708-945-7171",
            "fax_number": "708-919-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174710",
            "telephone_number": "312-929-2950",
            "fax_number": "312-224-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MOHAMED",
        "middle_name": "ATTIA",
        "name_prefix": "Dr.",
        "credential": "PT, DSC, MS, NCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017552",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "IL",
            "license": "4951",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070007653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM HEALTH",
            "identifier": "731267",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7488668",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL.  PPO",
            "identifier": "1628667",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2498142",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imani Alima Ibrahim
• Ishaq Ibrahim
• Israh Ibrahim
• Khalil Ibrahim, M.D.
• Manal Ibrahim, DMD
• Nadine Anne Ibrahim, LCSW
• Omer Ibrahim
• Sarah Ibrahim, MD
• Sideeq Ademola Ibrahim, MPH
• Sonia Ibrahim, PHARMD

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.