Provider Demographics
NPI:1861439911
Name:ROBERT S HECKLER DDS LTD
Entity Type:Organization
Organization Name:ROBERT S HECKLER DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:HECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:217-774-4221
Mailing Address - Street 1:101 W NORTH 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62565-1522
Mailing Address - Country:US
Mailing Address - Phone:217-774-4221
Mailing Address - Fax:217-774-5221
Practice Address - Street 1:101 W NORTH 1ST ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1522
Practice Address - Country:US
Practice Address - Phone:217-774-4221
Practice Address - Fax:217-774-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty