Provider Demographics
NPI:1154661643
Name:HERSHMAN, JANET CHARLA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:CHARLA
Last Name:HERSHMAN
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 1:61 CARIBOU XING
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1053
Mailing Address - Country:US
Mailing Address - Phone:847-559-1496
Mailing Address - Fax:
Practice Address - Street 1:1 BAXTER PKWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4625
Practice Address - Country:US
Practice Address - Phone:224-948-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.062215208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice