Individual
SCOTT HEINRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1750 W HARRISON ST, SUITE 108 KELLOGG, CHICAGO, IL 60612-3825
(312) 942-5110
Mailing address
1750 W HARRISON ST, SUITE 108 KELLOGG, CHICAGO, IL 60612-3825
(312) 942-5110
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036119625
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119625
—
IL
Enumeration date
11/15/2007
Last updated
10/28/2016
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