Provider Demographics
NPI:1134282866
Name:HIRSCH, ERICH GLATTMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERICH
Middle Name:GLATTMAN
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N MONTCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5566
Mailing Address - Country:US
Mailing Address - Phone:312-388-6684
Mailing Address - Fax:
Practice Address - Street 1:7045 VETERANS BLVD STE A1
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5681
Practice Address - Country:US
Practice Address - Phone:708-354-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-025337122300000X
IL19-0253371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist