Individual provider Active NPI

Marlyn D Hirsch, A.P.N.

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1386824597
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277000432 Issued in IL
Practice address
2565 King Drive
Chicago, IL 60616
Phone
(312) 808-7201
Fax
(708) 516-4777
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 209006984 IL
Nurse Practitioner 363L00000X 277000432 IL Primary
General Practice Registered Nurse 163WG0000X 041300563 IL

Addresses

Primary practice location

2565 King Drive
Chicago, IL 60616

Mailing address

2565 S. King Drive
Chicago, IL 60616
Phone (312) 808-7201

Other identifiers 1

IdentifierTypeStateIssuer
209006984OtherILADVANCED PRACTICE NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080407000017 IL Practitioner - Nurse Practitioner 9739266479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041300563ILMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Hospice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1386824597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 S. KING DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-808-7201",
            "fax_number": "708-516-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 KING DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-808-7201",
            "fax_number": "708-516-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "MARLYN",
        "middle_name": "D",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "209006984",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277000432",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041300563",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "209006984",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.