Provider Demographics
NPI:1083974232
Name:PIERCE, HEIDI A (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:A
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:1273 N EMERSON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-6672
Practice Address - Country:US
Practice Address - Phone:317-807-0770
Practice Address - Fax:317-807-0771
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008007A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist