Provider Demographics
NPI:1316911076
Name:HEDMAN, JOSHUA (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:HEDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 W ERIE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5704
Mailing Address - Country:US
Mailing Address - Phone:210-943-7246
Mailing Address - Fax:312-944-7246
Practice Address - Street 1:467 W ERIE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-5704
Practice Address - Country:US
Practice Address - Phone:210-943-7246
Practice Address - Fax:312-944-7246
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1751213ES0103X
IL016005182213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV07629Medicare UPIN
TXP00399540Medicare PIN
TX5834770001Medicare NSC
TX8F4798Medicare PIN