Provider Demographics
NPI:1316069321
Name:HERSH, BRADLEY STUART (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:STUART
Last Name:HERSH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1122 N CLARK ST APT 1701
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7879
Mailing Address - Country:US
Mailing Address - Phone:914-498-0723
Mailing Address - Fax:844-804-8331
Practice Address - Street 1:1122 N CLARK ST APT 1701
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7879
Practice Address - Country:US
Practice Address - Phone:914-498-0723
Practice Address - Fax:844-804-8331
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0627642083P0500X, 2083P0901X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine