Qudus A Ibrahim, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.298920 Issued in IL

Practice address

1500 S Lake Park Ave
Hobart, IN 46342-6638

Phone

(219) 940-6480

NPI assigned

Jan 1, 2018

Last updated

Jan 1, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1514764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1972010817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 RESERVE DR APT 115",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685239",
            "telephone_number": "708-574-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S LAKE PARK AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426638",
            "telephone_number": "219-940-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "QUDUS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-01",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026388A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.298920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Hobart, IN
• Providers in Hobart, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; 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.