Individual
KENNETH S HEIFERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7973 CHICAGO AVE, RIVER FOREST, IL 60305-1363
(708) 209-1111
Mailing address
7973 CHICAGO AVE, RIVER FOREST, IL 60305-1363
(708) 209-1111
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036067100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360671001
—
IL
Enumeration date
02/22/2006
Last updated
01/23/2017
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