Provider Demographics
NPI:1770473431
Name:IBRAHIM, KAREEM (APRN)
Entity type:Individual
Prefix:
First Name:KAREEM
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17605 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-5222
Mailing Address - Country:US
Mailing Address - Phone:708-516-1733
Mailing Address - Fax:
Practice Address - Street 1:17119 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7203
Practice Address - Country:US
Practice Address - Phone:708-942-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.476256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily