National Provider Identifier Database

ABBAS M IBRAHIM SR
Surgical


Contact Information

ABBAS M IBRAHIM SR
12935 S GREGORY STREET
BLUE ISLAND, IL60406
Phone: 708-597-2000
Fax:
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X

* Indicates primary specialty

NPI Profile & details for ABBAS M IBRAHIM SR

NPI Number 1396017984
Credentials
Entity Individual
Enumeration date 01/30/2012
Last updated 01/30/2012 - About 14 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 238.000314
Hospital affiliation n/a

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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