Individual
DR. MICHAEL J. HEATWOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7367 NORTH AVE, RIVER FOREST, IL 60305-1230
(978) 314-9349
Mailing address
7367 NORTH AVE, RIVER FOREST, IL 60305-1230
(708) 366-0066
(708) 366-0044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002232795
BLUECROSS BLUESHIELD IL
IL
01
—
0007859444
AETNA
IL
Enumeration date
11/22/2005
Last updated
07/08/2007
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