Organization
MADISON STREET CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E HEINS D.O. (PRESIDENT)
(815) 844-6106
Entity
Organization
Contact information
Practice address
520 W MADISON ST, PONTIAC, IL 61764-1729
(815) 844-6106
(815) 842-2526
Mailing address
520 W MADISON ST, PONTIAC, IL 61764-1729
(815) 844-6106
(815) 842-2526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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