Individual
MARY HEATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 W 2ND ST, ROCK FALLS, IL 61071-1005
(815) 626-2230
Mailing address
1300 W 2ND ST, ROCK FALLS, IL 61071-1005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041182453
IL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/01/2018
Last updated
11/14/2018
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