Provider Demographics
NPI:1942296041
Name:HIRSCH, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:901 MCCLINTOCK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0872
Mailing Address - Country:US
Mailing Address - Phone:888-220-6432
Mailing Address - Fax:630-654-4253
Practice Address - Street 1:13755 S. CICERO AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60445
Practice Address - Country:US
Practice Address - Phone:888-220-6432
Practice Address - Fax:708-385-7840
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA34340207RI0200X
IN01057045A207RI0200X
IL036-072340207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-072-340Medicaid
IAI10613Medicare PIN
ILL32317Medicare PIN
IL036-072-340Medicaid
ILL52062Medicare PIN
ILL82071Medicare PIN
ILC45218Medicare UPIN