Individual
AMIR J. HEYDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10350 HALIGUS RD STE 220, HUNTLEY, IL 60142-9585
(815) 455-2752
(815) 455-2789
Mailing address
10350 HALIGUS RD STE 220, HUNTLEY, IL 60142-9585
(815) 455-2752
(815) 455-2789
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036090794
IL
208D00000X
General Practice Physician
DR.0054524
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036090794
STATE LICENSE
IL
05
—
036090794
—
IL
01
—
DR.0054524
STATE LICENSE
CO
Enumeration date
10/13/2005
Last updated
12/19/2018
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