Individual
DR. IRA MARK LEBENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
307 W INDIANA AVE, URBANA, IL 61801-4939
(217) 367-1985
Mailing address
307 W INDIANA AVE, URBANA, IL 61801-4939
(217) 367-1985
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036046483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036046483
STATE LICENSE
IL
Enumeration date
11/23/2009
Last updated
03/07/2023
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