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NPI 1750171005

NPI 1750171005 : WILLIAM D HEIDKE DPT : ADDISON, TX

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General NPI Number Information
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    NPI Number           |    1750171005
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM D HEIDKE DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/09/2025
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    Last Update Date     |    11/13/2025
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Provider Practice Location Address
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    Address Line         |    14380 MARSH LN STE 120 
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    City                 |    ADDISON
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    State                |    TX
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    Zip                  |    75001-3879
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    Country              |    US
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    Telephone            |    972-942-2097
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2122 YORK RD STE 300 
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    City                 |    OAK BROOK
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    State                |    IL
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    Zip                  |    60523-1925
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    Country              |    US
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    Telephone            |    630-575-1980
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    Fax                  |    
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1407589
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    License Number State |    TX
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