Ibarra Interventional Pain Management SC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

036082621 Issued in IL

Legal business name

IBARRA INTERVENTIONAL PAIN MANAGEMENT SC

Practice address

1045 W Stephenson St
Freeport, IL 61032-4864

Phone

(815) 599-6159

NPI assigned

May 20, 2006

Last updated

Mar 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Juan M. Ibarra, M.D.NPI 1891817565

Title

President/Owner

Phone

(815) 235-2353

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Juan M Ibarra, MD

  • Specialist
  • Freeport, IL
  • NPI 1891817565
  Authorized official Same address or phone
• Alfred P Rosche III, M.D.

  • Interventional Pain Medicine Physician
  • Roscoe, IL
  • NPI 1962448332
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1023062460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610320123",
            "telephone_number": "815-235-2353",
            "fax_number": "815-235-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W STEPHENSON ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324864",
            "telephone_number": "815-599-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBARRA INTERVENTIONAL PAIN MANAGEMENT SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "IBARRA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "815-235-2353",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": "036082621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL PROVIDER #",
            "identifier": "08932005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Hotchkiss
• Jacob Hough, QMHP
• Hulsebus and Gehlsen Chiropractic
• Roger D Hulsebus, D.C.
• Nancy Hunziker
• Juan M Ibarra, MD
• Farouk Isawi, MD
• Hanny Isawi, MD
• Suzette Antoinette Isokpunwu
• Stephanie Iverson

• Legal Medicine in Freeport, IL
• Providers in Freeport, IL by specialty
• Legal Medicine in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.