MEDICARE: ELIZABETH A HEIL L.I.S.W.

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	104100000X	Social Worker	02464	IA

General Provider Information

NPI Number	:	1285697623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A HEIL L.I.S.W.

Provider Business Mailing Address
First Line	:	2728 ASBURY RD
Second Line	:	SUITE777
City	:	DUBUQUE
State	:	IA
Zip	:	52001-2971
Country	:	US
Telephone Number	:	563-556-9642
Fax Number	:	563-557-5030

Provider Business Practice Location Address
First Line	:	2728 ASBURY RD
Second Line	:	SUITE777
City	:	DUBUQUE
State	:	IA
Zip	:	52001-2971
Country	:	US
Telephone Number	:	563-556-9642
Fax Number	:	563-557-5030

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	01/06/2017

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