Irving, Jeremy

Irving, Jeremy is an individual health care provider with primary practice located at 2701 17Th St , Rock Island IL 61201-5351. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Irving, Jeremy can be contacted via phone (309) 779-5000.

Contact Information

Primary practice address
2701 17Th St Rock Island IL 61201-5351
Phone: (309) 779-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34419 Iowa
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036105497 Illinois

Profile Details

NPI number 1578536215
LBN Legal business name Irving, Jeremy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Dec 20th, 2022 - about 2 years ago

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 1578536215 NPPES
Other 210869 IHS
Other 93230 IHS
Other IL0181 IHS
Other 12105 IHS
Other IA0101 IHS
MEDICAID 2569475 IHS
MEDICAID 036105497002 IHS
Other 930126594 IHS
Other 93231 IHS
MEDICAID 0569475 IHS

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