MEDICARE: EDIE HARDIN

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
1	363A00000X	Physician Assistant	085.008661	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	085008661	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1417520149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDIE HARDIN

Provider Business Mailing Address
First Line	:	12531 E MEADOW DR
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-4152
Country	:	US
Telephone Number	:	316-644-5295
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 W CENTRAL RD STE 4500
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2388
Country	:	US
Telephone Number	:	847-398-2777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	01/28/2022

Similar Medicare Providers

1508132044 — MEGAN DORSEY APN-CNP
Practice Location Address:

880 W CENTRAL RD STE 4500
ARLINGTON HEIGHTS, IL
60005-2388

Practice Phone: 847-398-2777
Practice Fax: 847-394-2777

1972578698 — DR. WILLIS G PARSONS M.D.
Practice Location Address:

880 W CENTRAL RD STE 4500
ARLINGTON HEIGHTS, IL
60005-2388

Practice Phone: 847-725-8640
Practice Fax:

1467729897 — ALEX J LEVERENTZ PA
Practice Location Address:

880 W CENTRAL RD , STE 4500
ARLINGTON HEIGHTS, IL
60005-2388

Practice Phone: 217-383-6792
Practice Fax:

1992199947 — DR. DAVID MARK JANDURA MD
Practice Location Address:

880 W CENTRAL RD STE 4500
ARLINGTON HEIGHTS, IL
60005-2388

Practice Phone: 847-398-2777
Practice Fax: 847-394-2777

1699631853 — PAIGE ANNE EPPERSON PA-C
Practice Location Address:

880 W CENTRAL RD STE 4500
ARLINGTON HEIGHTS, IL
60005-2388

Practice Phone: 847-618-3060
Practice Fax: 847-618-5669

1811951411 — NIMIT K AGGARWAL M.D.
Practice Location Address:

12820 S RIDGELAND AVE , SUITE B
PALOS HEIGHTS, IL
60463-2388

Practice Phone: 708-371-8006
Practice Fax: 708-389-6630

Directions to “ EDIE HARDIN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.