Irwin, Bruce William

Irwin, Bruce William is an sole proprietor health care provider with primary practice located at 1800 Hollister Dr Suite 206, Libertyville IL 60048-5263. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Irwin, Bruce William can be contacted via phone (847) 549-1609.

Contact Information

Primary practice address
1800 Hollister Dr Suite 206 Libertyville IL 60048-5263
Phone: (847) 549-1609
Fax: (847) 549-1646
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 036086240 Illinois

Profile Details

NPI number 1891757720
LBN Legal business name Irwin, Bruce William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2006
Last updated Jan 5th, 2010 - about 14 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 1891757720 NPPES
Illinois MEDICAID 0360862401
Illinois Other 04920125

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