Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 036062811 | IL |
NPI | 1184685570 |
---|---|
Provider Name | Dr. Arthur Fred Hirsch |
First Address | La Grange Park, IL 60526-5512 |
Second Address | La Grange Park, IL 60526-5512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062811 | (05) | IL |
D14828 | (02) | IL |