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Individual

MARK IRWIN

Active
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Individual

MARK IRWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
336-023425
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000010019
ESSENCE
IL
05
036058840
IL
01
0450347
UHC
IL
01
113626
HEALTHLINK
IL
01
127443
GHP
IL
01
129537
BCBS TRI ST
IL
01
5561291
AETNA
IL
01
8221955
BCBS IL
IL
01
D14440
MERCY
IL
Enumeration date
11/04/2005
Last updated
09/21/2012
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