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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891757720 | NPPES |
| Illinois | MEDICAID | 0360862401 | |
| Illinois | Other | 04920125 |
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