MEDICARE: HEATHER WATSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	101YM0800X	Mental Health Counselor
3	261QM0850X	Adult Mental Health Clinic/Center
4	1041C0700X	Clinical Social Worker	149019788	IL
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
7	261QS1000X	Student Health Clinic/Center
8	252Y00000X	Early Intervention Provider Agency
9	390200000X	Student in an Organized Health Care Education/Training Program
10	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1285262287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER WATSON

Provider Business Mailing Address
First Line	:	1255 S MICHIGAN AVE APT 3105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 S MICHIGAN AVE APT 3105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3318
Country	:	US
Telephone Number	:	919-215-2674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	12/19/2025

Similar Medicare Providers

1811850571 — JAZMINE ROMAN
Practice Location Address:

5738 W WILSON AVE
CHICAGO, IL
60630-3318

Practice Phone: 312-885-8457
Practice Fax:

1922148378 — DR. GREGORY H. TIETZER D.D.S.
Practice Location Address:

3318 W FOSTER AVE
CHICAGO, IL
60625-4813

Practice Phone: 773-463-8860
Practice Fax: 773-463-9146

1699976803 — MS. JACQUELINE MOSES BROWN
Practice Location Address:

6223 S EBERHART AVE
CHICAGO, IL
60637-3318

Practice Phone: 773-203-2490
Practice Fax: 773-288-5239

1912185158 — SOUTHWEST SENIOR CENTER
Practice Location Address:

6117 S KEDZIE AVE
CHICAGO, IL
60629-3318

Practice Phone: 312-747-0440
Practice Fax:

1649442963 — RENAISSANCE ADULT DAY IN HOME CARE SERVICES, INC
Practice Location Address:

7920 S GREENWOOD AVE
CHICAGO, IL
60619-3318

Practice Phone: 773-723-9670
Practice Fax: 773-723-9677

1316270408 — 24SEVEN HEALTH CARE SERVICES INC.
Practice Location Address:

3318 W PETERSON AVE
CHICAGO, IL
60659-3510

Practice Phone: 773-463-3755
Practice Fax: 773-463-3744

Directions to “ HEATHER WATSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.