MEDICARE: DR. ELIE JOSE CHECO HEINSEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	01081393A	IN
2	207R00000X	Internal Medicine Physician	0101253601	VA
3	207R00000X	Internal Medicine Physician	01081393A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467764381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIE JOSE CHECO HEINSEN M.D.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2675 WINKLER AVE STE 200
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9328
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:	239-599-2612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	04/16/2026

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