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:
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Health care specialties

SpecialtyCodeLicense #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 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 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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