Individual
DR. ROBERT HEIDENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17850 KEDZIE AVE, SUITE 3500, HAZEL CREST, IL 60429-2058
(708) 799-8585
Mailing address
6850 HOHMAN AVE, HAMMOND, IN 46324-1410
(219) 931-7509
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036048186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048186
—
IL
Enumeration date
06/27/2005
Last updated
06/23/2008
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