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General NPI Number Information
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NPI Number | 1861666869
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Entity Type | Individual
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Provider Name | THERESE KIRSCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 820 S WOOD ST DEPT OF OBSTETRICS AND GYNECOLOGY
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone | 312-996-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 9809 PEDDLERS WAY
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City | ORLANDO
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State | FL
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Zip | 32817-1865
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Country | US
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Telephone | 407-342-1626
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036131504
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 86683
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License Number State | GA
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