Ibarra, Juan M

Ibarra, Juan M is an individual health care provider with primary practice located at 1045 W Stephenson St , Freeport IL 61032-4864. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ibarra, Juan M can be contacted via phone (815) 599-6159.

Contact Information

Primary practice address
1045 W Stephenson St Freeport IL 61032-4864
Phone: (815) 599-6159
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X Illinois

Profile Details

NPI number 1891817565
LBN Legal business name Ibarra, Juan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891817565 NPPES
Illinois Other 08932005 BCBS OF IL PROVIDER NBR

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