Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ibraheem Javeed Mohammed

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1477047124

Ibraheem Javeed Mohammed is a Pathology in Carbondale, Illinois. Qualified in 2005, 21 years ago. Practices with Southern Illinois Medical Services Nfp, a 332-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
21
Licensed in
IL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

405 W Jackson St
Carbondale, IL 62901-1462
Phone: (618) 549-0721
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 655 W 8th St Fl 4, Jacksonville, FL 32209-6511 — (904) 244-6930
  • 201 S 14th St, Herrin, IL 62948-3631 — (618) 942-2171
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036164689 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477047124
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 17, 2018
Last updated in NPPESSeptember 12, 2023
Certification dateSeptember 12, 2023
Mailing addressPo Box 3988, Carbondale, IL 62902-3988

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Southern Illinois Medical Services Nfp — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Carbondale