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Individual
HEATHER MECHELLE CLOUM
Active
Individual
HEATHER MECHELLE CLOUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036173797
IL
207Q00000X
Family Medicine Physician
73987-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138777
—
WI
Enumeration date
06/05/2015
Last updated
02/19/2026
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