Individual
HEIDI KLEMM-GLATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005183
IL
367500000X
Certified Registered Nurse Anesthetist
712147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R00489
MEDICARE PTAN
IL
Enumeration date
11/03/2006
Last updated
07/21/2022
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