Provider Demographics
NPI:1568972305
Name:HISER, ERIKA
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:HISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6995 E 1416 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT
Mailing Address - State:IL
Mailing Address - Zip Code:61841-6365
Mailing Address - Country:US
Mailing Address - Phone:217-621-3475
Mailing Address - Fax:
Practice Address - Street 1:516 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4677
Practice Address - Country:US
Practice Address - Phone:217-444-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist