Individual
DR. SHAWNA L HEDDINGHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Mailing address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009181
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05927400
BCBS
IL
01
—
419640
HEALTHLINK
—
01
—
5275510001
DMERC
—
01
—
DC6896
MEDICARE RR
—
01
—
K37256
MEDICARE AT EVC
IL
01
—
P00184209
PIN MEDICARE RR
—
Enumeration date
09/19/2005
Last updated
04/25/2008
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