Provider Demographics
NPI:1629211651
Name:HEATHER A. DOWNES, M.D., P.C., L.L.C.
Entity Type:Organization
Organization Name:HEATHER A. DOWNES, M.D., P.C., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOWNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-573-4633
Mailing Address - Street 1:4539 ELEANOR DR
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-5260
Mailing Address - Country:US
Mailing Address - Phone:773-573-4633
Mailing Address - Fax:
Practice Address - Street 1:800 N WESTMORELAND RD
Practice Address - Street 2:SUITE 100-B
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1673
Practice Address - Country:US
Practice Address - Phone:847-295-7700
Practice Address - Fax:847-295-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.120774207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty