Individual
LUCY IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1280 WINDHAM PKWY, ROMEOVILLE, IL 60446-1673
(815) 942-6323
(815) 942-6423
Mailing address
1401 LAKEWOOD DR, SUITE A, MORRIS, IL 60450-3352
(815) 942-6323
(815) 942-6423
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
036-072559
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036072559
—
IL
01
—
1626769
BCBS PROVIDER ID
IL
Enumeration date
09/26/2005
Last updated
12/20/2010
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