Provider Demographics
NPI:1184685570
Name:HIRSCH, ARTHUR FRED (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:FRED
Last Name:HIRSCH
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 1:600 N EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-5512
Mailing Address - Country:US
Mailing Address - Phone:708-579-3779
Mailing Address - Fax:
Practice Address - Street 1:600 N EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-5512
Practice Address - Country:US
Practice Address - Phone:708-579-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062811207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036062811Medicaid
ILL59153Medicare ID - Type Unspecified
IL036062811Medicaid