Provider Demographics
NPI:1740257963
Name:SILVERMAN, IRWIN M (MD)
Entity type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:M
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201
Mailing Address - Country:US
Mailing Address - Phone:847-869-1499
Mailing Address - Fax:847-869-2932
Practice Address - Street 1:1713 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-869-1499
Practice Address - Fax:847-869-2932
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057194207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036057194Medicaid
D14349Medicare UPIN
IL036057194Medicaid