Individual provider Active NPI

Amy E. Hedstrom, PA-C

  • Surgical Physician Assistant
  • Park Ridge, IL
National Provider Identifier
1396070801
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085001015 Issued in IL
Practice address
350 S Northwest Hwy Ste 106
Park Ridge, IL 60068-4262
Phone
(847) 470-1500
Fax
(847) 470-1550
NPI assigned
Oct 16, 2009
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085001015 IL Primary
Physician Assistant 363A00000X 085001015 IL

Addresses

Primary practice location

350 S Northwest Hwy Ste 106
Park Ridge, IL 60068-4262

Mailing address

350 S Northwest Hwy Ste 106
Park Ridge, IL 60068-4262
Phone (847) 470-1500

Other practice location 1

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 663-2652

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amyhedstrom@uropart.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091112000510 IL Practitioner - Physician Assistant 5597803437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 Central St
Evanston, IL 60201-1779

2180 Pfingsten Rd
Suite 3000
Glenview, IL 60026-1340
Phone (847) 503-3000

2650 Ridge Ave
Evanston, IL 60201-1700

767 Park Ave W
Suite B100
Highland Park, IL 60035-2469
Phone (847) 503-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085001015ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 1, 2018 Accepting new patients
Northwestern Memorial Physicians Group Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1396070801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 106",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-470-1500",
            "fax_number": "847-470-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 106",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-470-1500",
            "fax_number": "847-470-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011700",
            "country_code": "US",
            "telephone_number": "847-663-2652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDSTROM",
        "first_name": "AMY",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085001015",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amyhedstrom@uropart.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "350 S Northwest Hwy Ste 106",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.