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Organization

HEARTLAND INTERNAL MEDICINE LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHIMIN CAO (PRESIDENT)
(618) 998-9910
Entity
Organization

Contact information

Practice address
404 LINCOLN DR, HERRIN, IL 62948-3757
(618) 559-6549
Mailing address
3024 150TH PL, FLUSHING, NY 11354-2423
(618) 559-6549

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036110159
IL
Enumeration date
10/11/2006
Last updated
08/26/2013
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