Provider Demographics
NPI:1558366120
Name:HEIMAN, DAWN WOLCOTT (AUD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:WOLCOTT
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1019
Mailing Address - Country:US
Mailing Address - Phone:630-930-1025
Mailing Address - Fax:630-622-4784
Practice Address - Street 1:6440 MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1281
Practice Address - Country:US
Practice Address - Phone:630-930-1025
Practice Address - Fax:630-622-4784
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001250237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA089694Medicare ID - Type Unspecified