Healthcare Provider Details
I. General information
NPI: 1790752871
Provider Name (Legal Business Name): ERIN F HARDIES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4440 W 95TH ST
OAK LAWN IL
60453-2600
US
IV. Provider business mailing address
4440 W 95TH ST
OAK LAWN IL
60453-2600
US
V. Phone/Fax
- Phone: 708-684-4280
- Fax:
- Phone: 630-684-4280
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036-095907 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080H0002X |
| Taxonomy | Pediatric Hospice and Palliative Medicine Physician |
| License Number | 14208210-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: