Gamal Riad Ibrahim, PHYSICAL THERAPIST

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

6322 S Pulaski Rd
Chicago, IL 60629-4706

Phone

(708) 566-0816

Fax

(708) 233-0341

NPI assigned

Mar 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Allcare Therapeutic System

  • Physical Disabilities Residential Treatment Facility
  • Chicago, IL
  • NPI 1407020233
  NPD (past) Authorized official

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1922270099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W 111TH ST",
            "address_2": "#158",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553330",
            "telephone_number": "708-566-0816",
            "fax_number": "708-233-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294706",
            "telephone_number": "708-566-0816",
            "fax_number": "708-233-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "GAMAL",
        "middle_name": "RIAD",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-29",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Ibrahim
• Fadi Ibrahim, M.D.
• Fatima Ibrahim, O.D.
• Fazeelah Ibrahim, MD
• Filsan Ibrahim
• Hena Y Ibrahim, M.D
• Ibukunoluwa Ibrahim
• Imani Alima Ibrahim
• Ishaq Ibrahim
• Israh Ibrahim

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.