Healthcare Provider Details

I. General information

NPI: 1356544217
Provider Name (Legal Business Name): ROBERT M HEYMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 S ELMHURST RD
MOUNT PROSPECT IL
60056-4240
US

IV. Provider business mailing address

9280 HAMLIN AVE
DES PLAINES IL
60016-4238
US

V. Phone/Fax

Practice location:
  • Phone: 847-956-0070
  • Fax: 847-956-7736
Mailing address:
  • Phone: 847-635-9391
  • Fax: 847-635-0277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: