Individual
MRS. HEIDI MICHELLE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 W WASHINGTON ST STE 1500, CHICAGO, IL 60606-3485
(847) 502-4898
(847) 504-5015
Mailing address
PO BOX 772294, DETROIT, MI 48277-2294
(847) 504-5000
(508) 273-1241
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
105141
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
10/03/2025
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