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General NPI Number Information
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NPI Number | 1154661643
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Entity Type | Individual
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Provider Name | JANET CHARLA HERSHMAN MD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 1 BAXTER PKWY
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City | DEERFIELD
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State | IL
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Zip | 60015-4625
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Country | US
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Telephone | 224-948-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 61 CARIBOU XING
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City | NORTHBROOK
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State | IL
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Zip | 60062-1053
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Country | US
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Telephone | 847-559-1496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036.062215
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License Number State | IL
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