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ETHAN HOELDTKE PA-C
NPI 1194560227
Physician Assistant in Hazel Crest, IL

Active since June 29, 2024
17850 KEDZIE AVE STE 1150, HAZEL CREST, IL 60429(877) 692-8686 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 9, 2024, Jun 29, 2024 (2 updates tracked since 2024).

About Ethan Hoeldtke Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN HOELDTKE PA-C (NPI 1194560227) is an individual physician assistant in Hazel Crest, Illinois, licensed in Illinois (085.010882) and active in the NPI registry since June 2024. He maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1194560227
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameETHAN HOELDTKECredential: PA-C
Location Address17850 KEDZIE AVE STE 1150Hazel Crest, IL 60429-2095
Mailing Address19990 Governors HwyOlympia Fields, IL 60461-1021
Phone(877) 692-8686
Sole ProprietorNo
Enumeration DateJune 29, 2024
Last NPPES UpdateOctober 9, 20242 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1194560227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085.010882
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
17850 KEDZIE AVE STE 1150, Hazel Crest, IL 60429
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Secondary Practice Location 1

Location 13528 E 118th StChicago, IL 60617-7314 · Phone (877) 692-8686

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA ROSE SAFRANEK PA-C
Physician Assistant
17850 KEDZIE AVE STE 1150
HAZEL CREST, IL 60429
Cook County (877) 692-8686
AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
17850 KEDZIE AVE STE 1150
HAZEL CREST, IL 60429
Cook County (877) 692-8686

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Hoeldtke's NPI number?

The NPI number for Ethan Hoeldtke is 1194560227. It was assigned to this individual provider in the NPPES registry on June 29, 2024.

Where is Ethan Hoeldtke located?

Ethan Hoeldtke practices at 17850 Kedzie Ave Ste 1150, Hazel Crest, IL 60429. The listed phone number is (877) 692-8686.

What is Ethan Hoeldtke's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Ethan Hoeldtke was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.