Gregory Irwin Jr.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.012265 Issued in IL

Practice address

3416 Liberty Dr
Springfield, IL 62704-6520

Phone

(217) 793-3949

NPI assigned

Jun 5, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Springfield Psychological Center, LLC

  • Clinical Psychologist
  • Springfield, IL
  • NPI 1174749881

  Multi-Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1851959662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 LIBERTY DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046520",
            "telephone_number": "217-793-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 LIBERTY DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046520",
            "telephone_number": "217-793-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "GREGORY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.012265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Lee Iocca, RN,MS,BC-ADM,CDE
• Ippolito Teleoptometric Service, P.C.
• Ipsative Psychology, PLLC
• Afshan Iqbal, MD
• Rabia Iqbal, MD
• Megan Isaacs, PT
• Melinda K Isaacs, RPH
• Alexandra Marie Ishmael, LICENSED DIETITIAN
• Gizem Isiktas
• Ziad F Issa, M.D.

• Professional Counselor in Springfield, IL
• Providers in Springfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.