Search › Illinois › 152W00000X
Andrew Ibisch, OD
NPI 1700356912 · on the registry since 2018 · sole proprietor
Practice
- Address
- 1310 Dadrian Prof Park
Godfrey, IL 62035 - Phone
- (618) 433-5005
- Fax
- (618) 467-1053
Additional practice sites
- 610 Wesley Dr, Wood River, IL
- 110 Davidson Rd, Mount Vernon, IL
- 6660 Godfrey Rd, Godfrey, IL
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-12-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois