Provider Demographics
NPI:1174631741
Name:HEIER, DONALD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:S
Last Name:HEIER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3505
Mailing Address - Country:US
Mailing Address - Phone:773-279-1300
Mailing Address - Fax:773-279-1500
Practice Address - Street 1:3334 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3505
Practice Address - Country:US
Practice Address - Phone:773-279-1300
Practice Address - Fax:773-279-1500
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0060020468OtherBCBS
T36846Medicare UPIN
IL519390Medicare ID - Type Unspecified