Provider Demographics
NPI:1477925238
Name:STROO, HEATHER RAE (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:RAE
Last Name:STROO
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 1:375 N WALL ST STE P630
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3495
Mailing Address - Country:US
Mailing Address - Phone:815-937-2122
Mailing Address - Fax:815-937-2102
Practice Address - Street 1:375 N WALL ST STE P630
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3495
Practice Address - Country:US
Practice Address - Phone:815-937-2122
Practice Address - Fax:815-937-2102
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.013750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily