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

Q: 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.

Q: What is Fazeelah Ibrahim's specialty?

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

Q: 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 2 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.

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: August 02, 2026.

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

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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.

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

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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