Provider Demographics
NPI:1457379794
Name:CONNORS, HEATHER ANNE (MS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:CONNORS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N LAKE SHORE DR APT 6F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5219
Mailing Address - Country:US
Mailing Address - Phone:312-664-4094
Mailing Address - Fax:
Practice Address - Street 1:5758 S MARYLAND AVE
Practice Address - Street 2:MC9020 DCAM 4724
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1426
Practice Address - Country:US
Practice Address - Phone:773-834-7391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist