IndividualActive
Abbas Ibrahim
NPI 1396017984 · Surgical Physician Assistant · Blue Island, IL
Provider details
- NPI number
- 1396017984
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 238.000314 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
12935 S Gregory Street
Blue Island, IL 60406
Phone: (708) 597-2000
Approximate (ZIP-level) locationGet directions
Mailing address
10600 Brooks Lane
Chicago Ridge, IL 60415
Registry dates
- Enumerated
- 2012-01-30
- Last updated
- 2012-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.