Individual
KURT P HEINKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
26520 NETWORK PL, CHICAGO, IL 60673-1265
(630) 743-4500
Mailing address
3450 LACEY RD, DOWNERS GROVE, IL 60515-5430
(630) 743-4500
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
036.093294
IL
207Q00000X
Family Medicine Physician
036093294
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
036.093294
IL
207R00000X
Internal Medicine Physician
Primary
036093294
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04922838
BLUE SHIELD PROVIDER #
IL
Enumeration date
09/25/2006
Last updated
09/19/2013
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