Provider Demographics
NPI:1396389417
Name:HIRSCH ADVANCED PRACTICE PROVIDERS LTD
Entity Type:Organization
Organization Name:HIRSCH ADVANCED PRACTICE PROVIDERS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE NURSE
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:APN, DNP, FNP-BC
Authorized Official - Phone:708-571-0490
Mailing Address - Street 1:11422 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4120
Mailing Address - Country:US
Mailing Address - Phone:708-571-0490
Mailing Address - Fax:312-815-9535
Practice Address - Street 1:11422 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4120
Practice Address - Country:US
Practice Address - Phone:708-571-0490
Practice Address - Fax:312-815-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service