Provider Demographics
NPI:1821770470
Name:CHRACA, HEATHER D (CPHT, CMA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:CHRACA
Suffix:
Gender:F
Credentials:CPHT, CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 EASTWAY DR
Mailing Address - Street 2:
Mailing Address - City:ISLAND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60042-9408
Mailing Address - Country:US
Mailing Address - Phone:224-595-3579
Mailing Address - Fax:
Practice Address - Street 1:3817 EASTWAY DR
Practice Address - Street 2:
Practice Address - City:ISLAND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60042-9408
Practice Address - Country:US
Practice Address - Phone:224-595-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant