Individual
FREDRICK MICHAEL HETZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 W CONGRESS PKWY, CHICAGO, IL 60612-3809
(312) 942-4200
Mailing address
1717 W CONGRESS PKWY, CHICAGO, IL 60612-3809
(312) 942-4200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036159828
IL
208M00000X
Hospitalist Physician
Primary
036159828
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/20/2019
Last updated
08/04/2022
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