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General NPI Number Information
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NPI Number | 1073259594
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Entity Type | Individual
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Provider Name | JESSICA E HEDGER DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 05/08/2022
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Last Update Date | 05/08/2022
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Provider Practice Location Address
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Address Line | 2007 W BELMONT AVE STE 1E
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City | CHICAGO
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State | IL
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Zip | 60618-6793
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Country | US
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Telephone | 773-281-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 3136 PEORIA ST
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City | STEGER
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State | IL
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Zip | 60475-1037
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Country | US
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Telephone | 708-833-9374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 019.032212
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License Number State | IL
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