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Individual

ALISA KEARNEY HEITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
5700 S MARYLAND AVE, CHICAGO, IL 60637
(888) 824-0200
Mailing address
522 S CATHERINE AVE, LA GRANGE, IL 60525-2823
(206) 271-0751

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018421
IL
363LF0000X
Family Nurse Practitioner
21250
CA

Other

Enumeration date
09/18/2012
Last updated
12/28/2018
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