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General NPI Number Information
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NPI Number | 1629333240
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Entity Type | Individual
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Provider Name | NEVEIN F IBRAHIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 61838
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 61838
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 61838
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 61838-20
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License Number State | IL
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