Provider Demographics
NPI:1831159219
Name:HEGG, KARI ANN (PA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:HEGG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ANN
Other - Last Name:WOZNIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 SPRINGER DR
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6413
Mailing Address - Country:US
Mailing Address - Phone:815-744-8554
Mailing Address - Fax:
Practice Address - Street 1:7373 FRANCE AVE S STE 110
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4538
Practice Address - Country:US
Practice Address - Phone:763-231-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNP-475207Q00000X
MN9685207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN428935800Medicaid