Provider Demographics
NPI:1871518126
Name:HURT, FRANCINE L (DME)
Entity type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:L
Last Name:HURT
Suffix:
Gender:F
Credentials:DME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W 63RD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3316
Mailing Address - Country:US
Mailing Address - Phone:773-434-3780
Mailing Address - Fax:773-434-2335
Practice Address - Street 1:3301 W 63RD ST FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3316
Practice Address - Country:US
Practice Address - Phone:773-434-3780
Practice Address - Fax:773-476-2335
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1716890332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL300153204001Medicaid
IL4862190001Medicare NSC