Individual
KENNETH HEINRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-9100
Mailing address
75 REMITT DRIVE, LOCKBOX 3274, CHICAGO, IL 60675-3274
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101248860
VA
207P00000X
Emergency Medicine Physician
Primary
036-110486
IL
207P00000X
Emergency Medicine Physician
2009010649
MO
207P00000X
Emergency Medicine Physician
35.093955
OH
207P00000X
Emergency Medicine Physician
38590
IA
207P00000X
Emergency Medicine Physician
4301094015
MI
207P00000X
Emergency Medicine Physician
46549
TN
207P00000X
Emergency Medicine Physician
4845120
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036110486
BLUE SHIELD
IL
05
—
036110486
—
IL
05
—
036110486-3
—
IL
05
—
036110486-5
—
IL
05
—
036110486-6
—
IL
05
—
036110486-7
—
IL
05
—
036110486-8
—
IL
05
—
036110486-9
—
IL
05
—
1521933
—
TN
01
—
1891711743
BLUE SHIELD
IA
05
—
1891711743
—
IA
05
—
1891711743
—
MI
05
—
1891711743
—
MO
05
—
1891711743
—
VA
05
—
1891711743
—
WI
05
—
2976472
—
OH
05
—
7100112540
—
KY
01
—
P01731341
RAILROAD MEDICARE
VA
Enumeration date
07/14/2006
Last updated
02/06/2017
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