Provider Demographics
NPI:1003840133
Name:HIRSHMAN, MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:
Last Name:HIRSHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 WEST GOLF RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016
Mailing Address - Country:US
Mailing Address - Phone:847-824-3127
Mailing Address - Fax:847-824-3347
Practice Address - Street 1:8901 GOLF RD STE 300
Practice Address - Street 2:SUITE 300
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4029
Practice Address - Country:US
Practice Address - Phone:847-824-3127
Practice Address - Fax:847-824-3346
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036038113207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8010OtherADVOCATE HEALTH
IL0360381131Medicaid
IL0338490001OtherADMINISTAR FEDERAL
C39703Medicare UPIN
IL0338490001OtherADMINISTAR FEDERAL