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General NPI Number Information
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NPI Number | 1346122983
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Entity Type | Organization
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Legal Business Name | HEARTLAND EMERGENCY PHYSICIANS PLLC
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 8012 S CRANDON AVE
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City | CHICAGO
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State | IL
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Zip | 60617-1124
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Country | US
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Telephone | 773-356-5447
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Fax |
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Provider Business Mailing Address
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Address Line | 400 GALLERIA PKWY SE STE 960
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City | ATLANTA
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State | GA
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Zip | 30339-5980
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT
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Name | BOYKIN ROBINSON
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Credential |
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Telephone | 404-500-8147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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