Amr Ibrahim

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-008721 Issued in IL

Practice address

10632 Blue Heron Dr
Orland Park, IL 60467-5489

Phone

(708) 359-9997

Fax

(708) 873-9377

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Advance Rehab Services Inc.

  • Home Health Agency
  • Orland Park, IL
  • NPI 1407067648
  NPD (past)
• American Rehab Network,Inc.

  • Physical Therapist
  • Chicago, IL
  • NPI 1497884472
  NPD (past)
• Lexington Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Crestwood, IL
  • NPI 1710011945

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1669586707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10632 BLUE HERON DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675489",
            "telephone_number": "708-359-9997",
            "fax_number": "708-873-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 BLUE HERON DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675489",
            "telephone_number": "708-359-9997",
            "fax_number": "708-873-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "AMR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-008721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL GROUP #",
            "identifier": "01634214",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Hunter, OTR/L
• Mary Hurtienne, LCSW
• Rachel Hutchinson
• Kelly Hyde
• Thomas M. Iannucci, M.D.
• Cecilia Ibrahim, M.D.
• Nadia S Ibrahim
• Shukri Tarik Ideis, PHARMD
• Tarik S Ideis
• Anna Maria Ignaczewska, MD

• All providers in Orland Park, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.