Organization
HEARTLAND EMERGENCY SPECIALISTS, LLC
Active
Organization
HEARTLAND EMERGENCY SPECIALISTS, LLC
Active
Other names
HES, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DISSELKOEN CASTILLO MD (TREASURER)
(888) 437-0911
Entity
Organization
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Mailing address
2538 MOMENTUM PL, CHICAGO, IL 60689-0001
(616) 975-1845
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-078726
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732147
BCBS
IL
01
—
DG3753
RAILROAD MEDICARE
—
Enumeration date
09/23/2007
Last updated
07/09/2009
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