Ireland, Charles R

Ireland, Charles R is an individual health care provider with primary practice located at 430 Pennsylvania Ave Ste 150 , Glen Ellyn IL 60137-4464. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ireland, Charles R can be contacted via phone (888) 693-6437.

Contact Information

Primary practice address
430 Pennsylvania Ave Ste 150 Glen Ellyn IL 60137-4464
Phone: (888) 693-6437
Fax: (630) 432-6667
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-076070 Illinois

Profile Details

NPI number 1346268604
LBN Legal business name Ireland, Charles R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Aug 8th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346268604 NPPES
Illinois MEDICAID 036076070
Illinois Other L10947

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