Individual
JOSHUA HEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16255 HARLEM AVE, TINLEY PARK, IL 60477-1615
(708) 599-5000
Mailing address
16255 HARLEM AVE, TINLEY PARK, IL 60477-1615
(708) 599-5000
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000678
IL
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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