Ghislaine Imaris Ibarra-Brenneman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.024199 Issued in IL

Practice address

3011 N Clark St
Chicago, IL 60657

Phone

(773) 661-0240

Fax

(773) 289-1541

NPI assigned

Apr 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ghislaine Imaris Ibarra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1376107516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-661-0240",
            "fax_number": "773-289-1541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 N Western Ave Ste 510",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221788",
            "country_code": "US",
            "telephone_number": "773-269-6533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1431 N Western Ave Ste 510",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221788",
            "country_code": "US",
            "telephone_number": "773-269-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBARRA-BRENNEMAN",
        "first_name": "GHISLAINE",
        "middle_name": "IMARIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GHISLAINE",
            "last_name": "IBARRA",
            "middle_name": "IMARIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faye Gandeza Ibanez, CNP
• Onur Ibanoglu, MD
• Kaitlin S Ibara, OTR/L
• James Ibardaloza, P.T.
• Jose Antonio Ibarra Rodriguez
• Andrea Ibarra
• Carina Ibarra, A.A.S
• Gabriela Ibarra, FNP-BC
• Joshua Ibarra, DO
• Silvia Ibarra

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.