Individual
MR. DANIEL K. HEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2800 W 95TH STREET, EVERGREEN PARK, IL 60805-2746
(708) 422-6200
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(847) 615-2200
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041182916
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209000418
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430050994
RR MEDICARE
IL
Enumeration date
06/16/2006
Last updated
08/03/2010
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