| C J Ireland D O S C | |
|
4905 Old Orchard Ctr Skokie IL 60077-1425 | |
| (847) 679-6707 | |
| Not Available |
| Full Name | C J Ireland D O S C |
|---|---|
| Speciality | Internal Medicine |
| Location | 4905 Old Orchard Ctr, Skokie, Illinois |
| Authorized Official Name and Position | Cliff J Ireland (PRESIDENT) |
| Authorized Official Contact | 8476796707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C J Ireland D O S C 4905 Old Orchard Ctr Skokie IL 60077-1425 Ph: (847) 679-6707 | C J Ireland D O S C 4905 Old Orchard Ctr Skokie IL 60077-1425 Ph: (847) 679-6707 |
| NPI Number | 1083884993 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 05/21/2008 |
| Medicare PECOS PAC ID | 5698850063 |
|---|---|
| Medicare Enrollment ID | O20080310000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083884993 | NPI | - | NPPES |
| 01621317 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036071364 (Illinois) | Primary |
| Provider Name | Cliff J Ireland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952365116 PECOS PAC ID: 7214821867 Enrollment ID: I20051109000103 |
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