Ibrahim MD SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036088992 Issued in IL

Legal business name

IBRAHIM MD SC

Practice address

6720 167TH St
Suite 1
Tinley Park, IL 60477-2872

Phone

(708) 614-3000

Fax

(708) 614-3006

NPI assigned

Apr 14, 2016

Last updated

Apr 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hassan A Ibrahim, MDNPI 1578562781

Title

Physician

Phone

(708) 614-3000

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hassan A Ibrahim, M.D.

  • Internal Medicine Physician
  • Tinley Park, IL
  • NPI 1578562781
  NPD (past) Authorized official

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1689028714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 167TH ST",
            "address_2": "SUITE 1",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772872",
            "telephone_number": "708-614-3000",
            "fax_number": "708-614-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 167TH ST",
            "address_2": "SUITE 1",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772872",
            "telephone_number": "708-614-3000",
            "fax_number": "708-614-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBRAHIM MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-614-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036088992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeann Hussein
• Katie Huynh
• I J Healthcare Nursing Resource LLC
• Kathleen Lynn Ibarra, LCSW, CADC
• Ibrahim MD SC
• Hassan A Ibrahim, M.D.
• Kareem Ibrahim, APRN
• Nafisa B Ibrahim, MD
• Ican Dream Foundation Inc
• Icare Therapy Services Inc.

• Primary Care Clinic/Center in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.