Provider Demographics
NPI:1396868006
Name:IRWIN, CHRISTINE M (MT-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5046 W AINSLIE ST
Mailing Address - Street 2:FLR 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2303
Mailing Address - Country:US
Mailing Address - Phone:847-448-8335
Mailing Address - Fax:
Practice Address - Street 1:2008 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1017
Practice Address - Country:US
Practice Address - Phone:847-448-8335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist