Doctor Name: | LUCY IBRAHIM |
NPI Number: | 1184610107 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 036-072559 |
Business Practice Address: | 1280 Windham Pkwy Romeoville, IL - 604461673 |
Business Phone Number: | 8159426323 |
Business Fax Number: | 8159426423 |
Mailing Address: | 1401 Lakewood Dr, Suite A MORRIS |
State: | IL |
Postal Code: | 604503352 |
Phone Number: | 8159426323 |
Fax Number: | 8159426423 |
NPI Enumeration Date: | 09/26/2005 |
NPI Last Update Date: | 12/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 036-072559 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |