Provider Demographics
NPI:1386816007
Name:HEIMBUCH, BETH RENEE
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:RENEE
Last Name:HEIMBUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 SPRING RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1217
Mailing Address - Country:US
Mailing Address - Phone:847-951-2384
Mailing Address - Fax:
Practice Address - Street 1:1801 SPRING RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1217
Practice Address - Country:US
Practice Address - Phone:847-951-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist