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NPI Code Detail

MEDICARE: CHRISTINE M IRWIN MT-BC

MEDICARE: CHRISTINE M IRWIN MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225A00000XMusic Therapist

General Provider Information

NPI Number : 1396868006
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE M IRWIN MT-BC
Provider Business Mailing Address
First Line : 5046 W AINSLIE ST
Second Line : FLR 2
City : CHICAGO
State : IL
Zip : 60630-2303
Country : US
Telephone Number : 847-448-8335
Fax Number :
Provider Business Practice Location Address
First Line : 2008 DEMPSTER ST
Second Line :
City : EVANSTON
State : IL
Zip : 60202-1017
Country : US
Telephone Number : 847-448-8335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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Directions to “ CHRISTINE M IRWIN MT-BC” Practice Location

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