Healthcare Provider Details

I. General information

NPI: 1588191431
Provider Name (Legal Business Name): HEARTLAND WOMEN'S HEALTHCARE MO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 WENTZVILLE PKWY
WENTZVILLE MO
63385-3826
US

IV. Provider business mailing address

3230 VETERANS MEMORIAL DR
MOUNT VERNON IL
62864-5950
US

V. Phone/Fax

Practice location:
  • Phone: 618-997-5266
  • Fax: 833-431-2275
Mailing address:
  • Phone: 618-997-5266
  • Fax: 833-431-2275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL J SCHIFANO
Title or Position: PRESIDENT
Credential: MD
Phone: 618-997-5266