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NPI Code Detail

MEDICARE: ANDREW WILLIAM HARTMAN PSY D

MEDICARE: ANDREW WILLIAM HARTMAN PSY D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist041 004431IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101626932OTHERILBCBS

General Provider Information

NPI Number : 1316923790
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW WILLIAM HARTMAN PSY D
Provider Business Mailing Address
First Line : 75 BARRETT DRIVE
Second Line : #3
City : WEBSTER
State : NY
Zip : 14580
Country : US
Telephone Number : 847-310-1121
Fax Number : 847-844-1072
Provider Business Practice Location Address
First Line : 2500 W HIGGINS RD
Second Line : STE 1136
City : HOFFMAN ESTATES
State : IL
Zip : 60195-5220
Country : US
Telephone Number : 847-310-1121
Fax Number : 847-844-1072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 02/05/2025

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