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Contact Information

FADY M MOUSA IBRAHIM, DO
2160 S 1ST AVE
MAYWOOD, IL60153-3328
 Phone: 708-216-2687
 Fax: 708-216-5617
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurocritical Care

2084A2900X 86 Physician/Neuropsychiatry
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for FADY M MOUSA IBRAHIM · (Male)

NPI Number 1952807711
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/02/2018
Last updated 05/06/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036159688
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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