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Individual

DR. IBRAHIM MUSTAFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1304 FRANKLIN AVE, NORMAL, IL 61761-3558
(309) 454-1400
Mailing address
611 W PARK ST, URBANA, IL 61801-2501

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036156614
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/26/2017
Last updated
05/14/2026
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