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Individual

MADELEINE D HECKENKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNP

Contact information

Practice address
401 E CARPENTER ST, SPRINGFIELD, IL 62702-5104
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209012212
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209012212
APN LICENSE
IL
Enumeration date
11/19/2014
Last updated
12/19/2024
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