Ibrahim, Hassan A

Ibrahim, Hassan A is an sole proprietor health care provider with primary practice located at 16650 Harlem Ave Suite C, Tinley Park IL 60477-1847. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ibrahim, Hassan A can be contacted via phone (708) 614-3000.

Contact Information

Primary practice address
16650 Harlem Ave Suite C Tinley Park IL 60477-1847
Fax: (708) 614-3006
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036088992 Illinois

Profile Details

NPI number 1578562781
LBN Legal business name Ibrahim, Hassan A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2005
Last updated Mar 6th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578562781 NPPES
Illinois MEDICAID 036088992

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