Individual
DR. BRIAN FRANCIS HEATHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
PSYCHIATRIC ASSOCIATES OF CENTRAL ILLINOIS, 1124 S. SIXTH STREET, SPRINGFIELD, IL 62703
(217) 523-3143
(217) 523-7695
Mailing address
PSYCHIATRIC ASSOCIATES OF CENTRAL ILLINOIS, 1124 S. SIXTH STREET, SPRINGFIELD, IL 62703
(217) 523-3143
(217) 523-7695
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
071006614
IL
103TC0700X
Clinical Psychologist
Primary
071.006614
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732028
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/25/2006
Last updated
08/09/2022
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