Ibsen LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036057264 Issued in IL

Legal business name

IBSEN LLC

Practice address

16003 Executive Dr
Crest Hill, IL 60403-0500

Phone

(815) 744-2344

NPI assigned

Jul 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Rafael Perez-Guerra, MD

Title

President

Phone

(815) 744-2344

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1316387616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16003 EXECUTIVE DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030500",
            "telephone_number": "815-744-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16003 EXECUTIVE DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030500",
            "telephone_number": "815-744-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBSEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "PEREZ-GUERRA",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-744-2344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036057264",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "IL",
            "license": "036057264",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036057264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Hooten
• Hope Behavioral Services at the Jeannine Brent Center Incorporated
• Michelle L Horvath, PA-C
• Teneshia Monique Hudson, BSN,RN
• Eman Ibrahim
• Ibsen, LLC
• Inspire Therapy Services
• Integral Home Health Care, Inc.
• Nancy L Jarosik
• Jean L. Walsh Family Practitioner, LTD.

• General Practice Physician in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.