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Individual

DR. WILLIAM A HILGENDORF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
11725 N ILLINOIS ST, STE 3501, CARMEL, IN 46032-3008
(317) 688-2647
(317) 688-2921
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
20040359A
IN
103TC0700X
Clinical Psychologist
Primary
20040359A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100337310
IN
05
100337310B
IN
01
P00831908
RAILROAD MEDICARE
IN
Enumeration date
07/07/2005
Last updated
10/19/2021
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