Individual
DR. FADY MOHAMMED MOUSA-IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-2687
(708) 216-5617
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 759-4530
(815) 759-8053
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
036159688
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
05/06/2025
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