Provider Demographics
NPI:1477560126
Name:HENG, RAFE M (DO, FACC)
Entity Type:Individual
Prefix:DR
First Name:RAFE
Middle Name:M
Last Name:HENG
Suffix:
Gender:M
Credentials:DO, FACC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6812 STATE RTE 162 SUITE 202
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062
Mailing Address - Country:US
Mailing Address - Phone:618-288-1748
Mailing Address - Fax:618-288-1768
Practice Address - Street 1:6812 STATE RTE 162 SUITE 202
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062
Practice Address - Country:US
Practice Address - Phone:618-288-1748
Practice Address - Fax:618-288-1768
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036113077207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease