Individual
MARLYN D HIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.
Contact information
Practice address
2565 KING DRIVE, CHICAGO, IL 60616
(312) 808-7201
(708) 516-4777
Mailing address
2565 S. KING DRIVE, CHICAGO, IL 60616
(312) 808-7201
(708) 516-4777
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041300563
IL
164W00000X
Licensed Practical Nurse
Primary
209006984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006984
ADVANCED PRACTICE NURSE
IL
Enumeration date
11/06/2007
Last updated
02/22/2010
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