Individual
EDWARD J HEINISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 859-8700
Mailing address
2357 SEQUOIA DR, AURORA, IL 60506-6222
(630) 859-6800
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007861
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007861
—
IL
Enumeration date
07/10/2006
Last updated
11/23/2021
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