Provider Demographics
NPI:1790752871
Name:HARDIES, ERIN F (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:F
Last Name:HARDIES
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:A
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4440 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2600
Mailing Address - Country:US
Mailing Address - Phone:630-684-4280
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-095907208000000X
UT14208210-12052080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01216941OtherMEDICARE RAILROAD (INDIVIDUAL PTAN)
IL036095907Medicaid
IL487450006OtherMEDICARE PTAN (INDIVIDUAL)
ILCA4748OtherMEDICARE RAILROAD (GROUP PTAN)
ILCA4748OtherMEDICARE RAILROAD (GROUP PTAN)
IL487450Medicare PIN