Irwin, Mark
Irwin, Mark is an individual health care provider with primary practice located at 2900 Frank Scott Pkwy W Suite 904, Belleville IL 62223-5000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Irwin, Mark can be contacted via phone (618) 234-0640.Contact Information
Primary practice address
2900 Frank Scott Pkwy W Suite 904
Belleville IL 62223-5000
Phone: (618) 234-0640
Fax: (314) 851-4475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 336-023425 | Illinois |
Profile Details
| NPI number | 1366433567 |
|---|---|
| LBN Legal business name | Irwin, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Sep 21st, 2012 - about 13 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 | 1366433567 | NPPES |
| Illinois | MEDICAID | 036058840 | |
| Illinois | Other | 000000010019 | |
| Illinois | Other | 113626 | |
| Illinois | Other | 8221955 | |
| Illinois | Other | 127443 | |
| Illinois | Other | 129537 | |
| Illinois | Other | 129537 | |
| Illinois | Other | 0450347 | |
| Illinois | Other | 5561291 | |
| Illinois | Other | D14440 |
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