Provider Demographics
NPI:1568057131
Name:HEARTLAND WOMEN'S HEALTHCARE IL PC
Entity Type:Organization
Organization Name:HEARTLAND WOMEN'S HEALTHCARE IL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIFANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:618-997-5266
Mailing Address - Street 1:3230 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-5950
Mailing Address - Country:US
Mailing Address - Phone:618-997-5266
Mailing Address - Fax:618-997-5285
Practice Address - Street 1:1170 FORTUNE BLVD
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-7358
Practice Address - Country:US
Practice Address - Phone:618-997-5266
Practice Address - Fax:618-997-5285
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND WOMEN'S HEALTHCARE LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty