Individual
SUE ANN HEIRONIMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(312) 766-4949
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-5196
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008543
IL
Other
Enumeration date
05/20/2020
Last updated
12/21/2022
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