Provider Demographics
NPI:1205134749
Name:BEUCHER, HEIDI (LAC)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BEUCHER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 N WABASH AVE
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-2406
Mailing Address - Country:US
Mailing Address - Phone:708-220-1979
Mailing Address - Fax:
Practice Address - Street 1:203 N WABASH AVE
Practice Address - Street 2:SUITE 1007
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-2406
Practice Address - Country:US
Practice Address - Phone:708-220-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000963171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist