Henderson, Heidi
Henderson, Heidi is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Henderson, Heidi can be contacted via phone (309) 672-5733.Contact Information
Primary practice address
221 Ne Glen Oak Ave
Peoria IL 61636-0001
Phone: (309) 672-5733
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | Illinois |
Profile Details
| NPI number | 1558485938 |
|---|---|
| LBN Legal business name | Henderson, Heidi |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558485938 | NPPES |
| Illinois | Other | 7215059 | BCBS PPO |
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