Individual
DR. BRUCE MICHAEL HERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6763 N MILWAUKEE AVE, NILES, IL 60714-4418
(847) 297-2181
(847) 297-0248
Mailing address
6763 N MILWAUKEE AVE, NILES, IL 60714-4418
(847) 297-2181
(847) 297-0248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-074614
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036074614
—
IL
01
—
786940
MEDICARE ID
IL
Enumeration date
02/15/2006
Last updated
01/25/2021
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