Individual
HAKEEM I. JIBAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
801 MACARTHUR BLVD STE 400A, MUNSTER, IN 46321-2923
(219) 836-7602
(219) 836-7605
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02004129A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
02004129A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
036139308
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201164640
—
IN
Enumeration date
04/02/2010
Last updated
01/10/2023
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