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Organization
IBARRA INTERVENTIONAL PAIN MANAGEMENT SC
Active
Organization
IBARRA INTERVENTIONAL PAIN MANAGEMENT SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN M. IBARRA M.D. (PRESIDENT/OWNER)
(815) 235-2353
Entity
Organization
Contact information
Practice address
1045 W STEPHENSON ST, FREEPORT, IL 61032-4864
(815) 599-6159
Mailing address
PO BOX 123, FREEPORT, IL 61032-0123
(815) 235-2353
(815) 235-2353
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
036082621
IL
Other
Enumeration date
05/20/2006
Last updated
03/29/2010
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