Individual
ANDREW EHEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
810 W ANTHONY DR, URBANA, IL 61802-7431
(217) 326-2911
(217) 326-2996
Mailing address
611 W PARK ST, URBANA, IL 61801-2500
(217) 326-2911
(217) 326-2996
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017135
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROV ID
—
01
—
203
BLUE CROSS PROV ID
IL
01
—
4117
HAMP PROVIDER ID
IL
01
—
7216
PERSONALCARE PROV ID
—
Enumeration date
07/28/2009
Last updated
07/28/2009
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