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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