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Organization
OSTEOPATHIC SPORTS MEDICINE, S.C.
Active
Organization
OSTEOPATHIC SPORTS MEDICINE, S.C.
Active
Other names
Chicago Osteopathic Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT P HEINKING D.O. (PRESIDENT)
(630) 455-0212
Entity
Organization
Contact information
Practice address
6715 KINGERY HWY, WILLOWBROOK, IL 60527-5142
(630) 455-0212
Mailing address
6715 KINGERY HWY, WILLOWBROOK, IL 60527-5142
(630) 455-0212
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04922838
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/25/2006
Last updated
02/07/2008
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