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Individual

DR. HEIDI LYNN GADDEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1801 W WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-6104
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-6104

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036109782
IL
207Q00000X
Family Medicine Physician
27379
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27379
NE STATE LICENSE
NE
Enumeration date
09/28/2005
Last updated
01/15/2025
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