Individual
MARICELA IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W LAKE ST, ADDISON, IL 60101-1101
(630) 221-4739
Mailing address
111 N COUNTY FARM RD, WHEATON, IL 60187-3988
(630) 221-4739
(630) 510-5464
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
17100725
IL
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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