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Individual

OMER IBRAHIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
515 N STATE ST STE 900, CHICAGO, IL 60654
(312) 245-9965
(312) 245-9964
Mailing address
515 N STATE ST STE 900, CHICAGO, IL 60654-9104
(312) 245-9965
(312) 245-9964

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036143080
IL
207NS0135X
Procedural Dermatology Physician
036.143080
IL

Other

Enumeration date
03/28/2012
Last updated
04/13/2022
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