Provider Demographics
NPI:1669495743
Name:HERBOLSHEIMER, HEATHER R (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:R
Last Name:HERBOLSHEIMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22285 N PEPPER RD STE 111
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2539
Mailing Address - Country:US
Mailing Address - Phone:847-382-7330
Mailing Address - Fax:847-382-9654
Practice Address - Street 1:27401 W IL ROUTE 22
Practice Address - Street 2:SUITE 111
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5999
Practice Address - Country:US
Practice Address - Phone:847-382-2320
Practice Address - Fax:847-842-1501
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103219207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1669495743Medicaid