Individual ProviderGregory IrwinCounselorBehavioral Health & Social Service ProvidersPractice Address3416 Liberty Dr, Springfield, IL 62704-6520(217) 793-3949PECOS EnrollmentBased on the most recent information from CMS, provider Gregory Irwin does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1851959662Provider TypeIndividualFull NameIrwin, GregoryGenderMaleSole ProprietorYesEnumeration Date6/5/2019Last Updated6/5/2019Contact InformationPractice LocationPractice Address3416 Liberty Dr, Springfield, IL 62704-6520Phone(217) 793-3949FaxUnlisted FaxMailing LocationMailing Address3416 Liberty Dr, Springfield, IL 62704-6520Phone(217) 793-3949FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180.012265Illinois