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FAZEELAH IBRAHIM MD
NPI 1053975722
Family Medicine - Addiction Medicine in Chicago, IL

Active since April 27, 2019PECOS Enrolled
1220 S WOOD ST, CHICAGO, IL 60608(312) 996-2000 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 24, 2023, Jul 21, 2022, Apr 27, 2019 (3 updates tracked since 2019).

About Fazeelah Ibrahim Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAZEELAH IBRAHIM MD (NPI 1053975722) is an individual addiction medicine provider in Chicago, Illinois, licensed in Illinois (336.123413) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1053975722
Entity TypeIndividualFemale
Primary Taxonomy207QA0401X
Provider Legal NameFAZEELAH IBRAHIMCredential: MD
Location Address1220 S WOOD STChicago, IL 60608-1202
Mailing Address1220 S Wood StChicago, IL 60608-1202 · (312) 996-2000
Phone(312) 996-2000
Sole ProprietorNo
Enumeration DateApril 27, 2019
Last NPPES UpdateOctober 24, 20233 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1053975722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in IL · 336.123413
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 336.123413 (IL)
1220 S WOOD ST, Chicago, IL 60608
Open in Google Maps ↗

Secondary Practice Location 1

Location 1820 S Damen AveChicago, IL 60612-3728 · Phone (312) 569-8387

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fazeelah Ibrahim Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Fazeelah Ibrahim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Board Of Trustees Of The University Of Illinois
Same address
Federally Qualified Health Center (FQHC)
1220 S. WOOD STREET, UIH-MILE SQUARE HEALTH CENTER
Chicago, IL 60608
  • Reassigned Medicare billing, Illinois enrollment
  • 113 clinicians in this Medicare group
NPI 1669493466 (312) 413-1261
Sapphire At Gresham Rehab, LLC
1,745 mi
Skilled Nursing Facility
405 NE 5TH ST
Gresham, OR 97030
  • Reassigned Medicare billing, Oregon enrollment
  • Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
  • 3,207 clinicians in this Medicare group
NPI 1033740899 (503) 666-5600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60608 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACY A ABRAHAM
Advanced Practice Midwife
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
STEPHANIE E PEDROZA PA-C
Physician Assistant
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
CYNTHIA JACINTHE APN, PMHNP-BC, CNM
Nurse Practitioner (Psychiatric/Mental Health)
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
TAYLOR CHAREST MD
Family Medicine
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
DR. MELISSA RAY HOUSE APRN, CNM, WHNP-BC
Advanced Practice Midwife
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
MS. ALLEGRA ROSE CONNORS
Nurse Practitioner (Psychiatric/Mental Health)
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
MS. SARA EIFRID FLANAGAN APN
Nurse Practitioner (Psychiatric/Mental Health)
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000
CAROLA MORALES
Dental Hygienist
1220 S WOOD ST
CHICAGO, IL 60608
Cook County (312) 996-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fazeelah Ibrahim's NPI number?

The NPI number for Fazeelah Ibrahim is 1053975722. It was assigned to this individual provider in the NPPES registry on April 27, 2019.

Where is Fazeelah Ibrahim located?

Fazeelah Ibrahim practices at 1220 S Wood St, Chicago, IL 60608. The listed phone number is (312) 996-2000.

What is Fazeelah Ibrahim's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Is Fazeelah Ibrahim enrolled in Medicare?

Yes. Fazeelah Ibrahim is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Fazeelah Ibrahim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Fazeelah Ibrahim reassigns Medicare benefits to 2 organizations: The Board Of Trustees Of The University Of Illinois (Chicago, IL) and Sapphire At Gresham Rehab, LLC (Gresham, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Fazeelah Ibrahim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Fazeelah Ibrahim was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.