Individual
DR. JEREMY IRVING
Active
Individual
DR. JEREMY IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036105497
IL
207P00000X
Emergency Medicine Physician
34419
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105497002
—
IL
05
—
0569475
—
IL
01
—
12105
BCWELLMARK TP
—
01
—
210869
IHS
—
05
—
2569475
—
IL
01
—
930126594
RR MEDICARE
—
01
—
93230
BCWELLMARK WEST
—
01
—
93231
BCWELLMARK 7TH ST
—
01
—
IA0101
JOHN DEERE
—
01
—
IL0181
JOHN DEERE ILLINOIS
—
Enumeration date
02/13/2006
Last updated
12/20/2022
Update your record
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