Individual
SCOTT RICHARD HEELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1252 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(224) 424-4624
Mailing address
1942 FRANKLIN CT, GURNEE, IL 60031-6307
(847) 714-3316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006635
IL
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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