Provider Demographics
NPI:1679004824
Name:HILTUNEN, AUDREY R (MD)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:R
Last Name:HILTUNEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S HIGH ST
Mailing Address - Street 2:OSU/NCH INTERNAL MEDICINE-PEDIATRICS R
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1043
Mailing Address - Country:US
Mailing Address - Phone:614-355-9000
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE # R
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.141176207R00000X, 208000000X, 208M00000X
IL036161298208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.141176OtherOHIO STATE MEDICAL BOARD