Theodore M Hirschfeld, MS, ATC, OTC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096-000725 Issued in IL

Practice address

200 Amber CT
West Chicago, IL 60185-5107

Phone

(847) 830-9899

Fax

(847) 574-7439

NPI assigned

Sep 20, 2005

Last updated

Dec 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1720074354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AMBER CT",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601855107",
            "telephone_number": "847-830-9899",
            "fax_number": "847-574-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AMBER CT",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601855107",
            "telephone_number": "847-830-9899",
            "fax_number": "847-574-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCHFELD",
        "first_name": "THEODORE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MS, ATC, OTC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-000725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in West Chicago, IL
• Providers in West Chicago, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.