Provider Demographics
NPI:1477512622
Name:HEILIGER, JASON JAMES (ATC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:JAMES
Last Name:HEILIGER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 STAMFORD CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-6547
Mailing Address - Country:US
Mailing Address - Phone:630-820-2272
Mailing Address - Fax:
Practice Address - Street 1:4334 FOX VALLEY CENTER DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7945
Practice Address - Country:US
Practice Address - Phone:630-236-7544
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer