Individual
MR. BRIAN ANTHONY HEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-3406
Mailing address
10116 LAWRENCE CT, OAK LAWN, IL 60453-3851
(708) 743-5448
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
209014334
IL
Other
Enumeration date
02/17/2016
Last updated
12/06/2021
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