Provider Demographics
NPI:1205367448
Name:HEIM, COURTNEY (DO)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HEIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 W.DEMPSTER STREET - PARK SIDE PROFESSIONAL CENTER
Mailing Address - Street 2:STE 470
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-795-3100
Mailing Address - Fax:
Practice Address - Street 1:1875 W.DEMPSTER STREET - PARK SIDE PROFESSIONAL CENTER
Practice Address - Street 2:STE 470
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-795-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1512232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry