Provider Demographics
NPI:1952623928
Name:TSIRLINE, IRENE (PA-C)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:TSIRLINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:CHUBINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:347 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1077
Mailing Address - Country:US
Mailing Address - Phone:847-549-7022
Mailing Address - Fax:
Practice Address - Street 1:347 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1077
Practice Address - Country:US
Practice Address - Phone:847-549-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003657363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant