Provider Demographics
NPI:1447790977
Name:HEILMAN, PAMELA (PSYD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 BETHANY RD
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3124
Mailing Address - Country:US
Mailing Address - Phone:779-777-7335
Mailing Address - Fax:815-758-8441
Practice Address - Street 1:1625 BETHANY RD
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178
Practice Address - Country:US
Practice Address - Phone:779-777-7335
Practice Address - Fax:815-758-8441
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009753103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical