Individual
ANN MARTHA MARIE IBBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 N PLEASANT AVE, CENTRALIA, IL 62801-3056
(618) 436-8000
Mailing address
1120 N 1ST ST, BREESE, IL 62230-1736
(217) 971-4764
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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