Individual
MARY MARTHA HEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
2398 BLUE SPRUCE LN, AURORA, IL 60502-6386
(630) 677-9243
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
01/05/2019
Last updated
05/11/2019
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