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General NPI Number Information
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NPI Number | 1053298174
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Entity Type | Individual
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Provider Name | GABRIELA IBARRA FNP-BC
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Gender |
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 6524 RIDGE DR
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-1827
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Country | US
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Telephone | 773-663-1664
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Fax |
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Provider Business Mailing Address
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Address Line | 5521 S KEDZIE AVE UNIT 106
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City | CHICAGO
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State | IL
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Zip | 60629-2448
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Country | US
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Telephone | 773-306-2546
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.032956
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License Number State | IL
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