MEDICARE: SARAH JANE HULSTEDT DPT

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	225100000X	Physical Therapist	070039851	IL

General Provider Information

NPI Number	:	1457296022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JANE HULSTEDT DPT

Provider Business Mailing Address
First Line	:	PO BOX 735263
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-5263
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 BELOIT RD
Second Line	:
City	:	BELVIDERE
State	:	IL
Zip	:	61008-1745
Country	:	US
Telephone Number	:	815-398-9491
Fax Number	:	815-381-7498

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

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	05/26/2026

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