Individual
DR. HASSAN A IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16650 HARLEM AVE, SUITE C, TINLEY PARK, IL 60477-1847
(708) 614-3000
(708) 614-3006
Mailing address
PO BOX 518, TINLEY PARK, IL 60477-0518
(708) 614-3000
(708) 614-3006
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088992
—
IL
Enumeration date
07/19/2005
Last updated
03/06/2012
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