Provider Demographics
NPI:1851444004
Name:HIRSH, BRADLEY H (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:H
Last Name:HIRSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2948 N NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4832
Mailing Address - Country:US
Mailing Address - Phone:773-549-5040
Mailing Address - Fax:773-549-5071
Practice Address - Street 1:2828 N CLARK ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5775
Practice Address - Country:US
Practice Address - Phone:773-549-5040
Practice Address - Fax:773-549-5071
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor