Individual
CHARLES RICHARD HEINZMANN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036154075
IL
Other
Enumeration date
04/06/2018
Last updated
07/07/2023
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