Healthcare Provider Details

I. General information

NPI: 1982701694
Provider Name (Legal Business Name): HESTER J. HURSH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HESTER J. HURSH-CASTRO M.D.

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 W BELVIDERE RD
GRAYSLAKE IL
60030-2306
US

IV. Provider business mailing address

261 W BELVIDERE RD
GRAYSLAKE IL
60030-2306
US

V. Phone/Fax

Practice location:
  • Phone: 708-224-9042
  • Fax:
Mailing address:
  • Phone: 708-224-9042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number036-039801
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: