Provider Demographics
NPI:1316923790
Name:HARTMAN, ANDREW WILLIAM (PSY D)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:WILLIAM
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 BARRETT DRIVE
Mailing Address - Street 2:#3
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580
Mailing Address - Country:US
Mailing Address - Phone:847-310-1121
Mailing Address - Fax:847-844-1072
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:STE 1136
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-5220
Practice Address - Country:US
Practice Address - Phone:847-310-1121
Practice Address - Fax:847-844-1072
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041 004431103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01626932OtherBCBS
IL01626932OtherBCBS