Provider Demographics
NPI:1962137885
Name:IBRAIHM, MAJD (DR)
Entity type:Individual
Prefix:
First Name:MAJD
Middle Name:
Last Name:IBRAIHM
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14322 S WILL COOK RD
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-9211
Mailing Address - Country:US
Mailing Address - Phone:708-732-5700
Mailing Address - Fax:708-732-5701
Practice Address - Street 1:14322 S WILL COOK RD
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-9211
Practice Address - Country:US
Practice Address - Phone:708-732-5700
Practice Address - Fax:708-732-5701
Is Sole Proprietor?:No
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.3047581835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist