Provider Demographics
NPI:1275529869
Name:IRLANDA, IRIA E (MD)
Entity Type:Individual
Prefix:
First Name:IRIA
Middle Name:E
Last Name:IRLANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BIESTERFIELD RD STE 213
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-7300
Mailing Address - Country:US
Mailing Address - Phone:847-690-9767
Mailing Address - Fax:
Practice Address - Street 1:901 BIESTERFIELD RD STE 213
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-7300
Practice Address - Country:US
Practice Address - Phone:847-690-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094884207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14611OtherADVOCATE CHRIST ID
IL21622441OtherBCBS PROVIDER ID
IL0360948842Medicaid
IL110207905OtherRAILROAD MEDICARE
IL36296015803OtherADVOCATE HEALTH CTR ID
ILK40883Medicare PIN
ILL77965Medicare PIN