Provider Demographics
NPI:1508871476
Name:SOLOMON, IREN (MD)
Entity type:Individual
Prefix:
First Name:IREN
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S LORRAINE RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5942
Mailing Address - Country:US
Mailing Address - Phone:630-670-2744
Mailing Address - Fax:
Practice Address - Street 1:507 S LORRAINE RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5942
Practice Address - Country:US
Practice Address - Phone:630-670-2744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336071449208000000X
IN99031067A208000000X
IL036107741208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I61060Medicare UPIN