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General NPI Number Information
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NPI Number | 1558857573
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Entity Type | Individual
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Provider Name | ERIN ILYSE HEFFEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 75 S MILWAUKEE AVE
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City | WHEELING
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State | IL
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Zip | 60090
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Country | US
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Telephone | 847-465-0800
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Fax | 947-465-0053
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Provider Business Mailing Address
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Address Line | 822 FOREST AVE
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City | DEERFIELD
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State | IL
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Zip | 60015-2917
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Country | US
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Telephone | 847-347-4732
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Fax | 847-945-7812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.031772
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License Number State | IL
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