Provider Demographics
NPI:1275687899
Name:HEIL, NANCY J (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:HEIL
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 1:10436 SOUTHWEST HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415
Mailing Address - Country:US
Mailing Address - Phone:708-636-0700
Mailing Address - Fax:708-636-3849
Practice Address - Street 1:10436 SOUTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415
Practice Address - Country:US
Practice Address - Phone:708-636-0700
Practice Address - Fax:708-636-3849
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
D14180Medicare UPIN