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General NPI Number Information
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NPI Number | 1740340330
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE TREATMENT CENTER OF CHICAGO, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 467 W ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60654-5704
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Country | US
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Telephone | 312-943-7246
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Fax | 312-944-7246
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Provider Business Mailing Address
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Address Line | 467 W ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60654-5704
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Country | US
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Telephone | 312-943-7246
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Fax | 312-944-7246
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOSHUA HEDMAN
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Credential | DPM
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Telephone | 312-943-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0156005182
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License Number State | IL
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