Provider Demographics
NPI:1184450074
Name:SHALABI, IBRAHIM HASSAN
Entity type:Individual
Prefix:
First Name:IBRAHIM
Middle Name:HASSAN
Last Name:SHALABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 W POTTAWATOMI DR
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2021
Mailing Address - Country:US
Mailing Address - Phone:708-238-4864
Mailing Address - Fax:
Practice Address - Street 1:26 S PROSPECT ST STE 204
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2252
Practice Address - Country:US
Practice Address - Phone:413-206-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health