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General NPI Number Information
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NPI Number | 1609675818
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Entity Type | Organization
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Legal Business Name | HEARTFELT MEDICAL PLLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 20550 S LAGRANGE RD STE 10
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City | FRANKFORT
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State | IL
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Zip | 60423-1699
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Country | US
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Telephone | 708-821-3923
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Fax |
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Provider Business Mailing Address
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Address Line | 20015 S LAGRANGE RD # 1019
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City | FRANKFORT
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State | IL
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Zip | 60423-3104
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Country | US
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Telephone | 708-821-3923
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Fax | 478-202-9614
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Authorized Official
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Title or Position | MANAGER
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Name | REBECCA BROTCKE
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Credential |
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Telephone | 815-986-0855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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