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General NPI Number Information
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NPI Number | 1912324302
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Entity Type | Individual
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Provider Name | MATTHEW GLENN HIRE MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 251 E HURON ST # F5-704
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City | CHICAGO
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State | IL
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Zip | 60611-2908
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Country | US
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Telephone | 312-472-3585
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Fax |
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-695-8585
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.148854
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License Number State | IL
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