Provider Demographics
NPI:1477817138
Name:HEFFERON, MARGARET M (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:HEFFERON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 830
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-943-7850
Mailing Address - Fax:312-943-2955
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:SUITE 830
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-943-7850
Practice Address - Fax:312-943-2955
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009563363LF0000X
IL041.350457163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse