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Individual

JACOB DANIEL HEETER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNA

Contact information

Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
7700 MAJOR AVE, BURBANK, IL 60459-1312

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
IL

Other

Enumeration date
04/29/2020
Last updated
04/29/2020
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