Active NPI
Ahmed Ibrahim, SA-C
- Surgical Assistant
- Chicago, IL
National Provider Identifier
1689102428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 16-580
- Practice address
- 2320 E 93Rd St
Chicago, IL 60617-3909 - Phone
- (773) 967-2000
- NPI assigned
- May 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 16-580 | CO | Primary |
Addresses
Primary practice location
2320 E 93Rd St
Chicago, IL 60617-3909
Mailing address
1351 Verandah Dr
Valparaiso, IN 46385-7081
Phone (219) 299-1421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16-580 | CO | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1689102428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1351 VERANDAH DR",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463857081",
"telephone_number": "219-299-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2320 E 93RD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606173909",
"telephone_number": "773-967-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "AHMED",
"credential": "SA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-24",
"last_updated": "2022-05-17",
"certification_date": "2022-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "CO",
"license": "16-580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.