Individual
LAURA M IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 990-5522
(847) 573-4281
Mailing address
2000 GREEN RD, ANN ARBOR, MI 48105-1598
(734) 993-3764
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003270
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962668590
—
WI
Enumeration date
08/04/2008
Last updated
12/28/2021
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