MEDICARE: JAMIE HEEMIN AN BA MS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1639057953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE HEEMIN AN BA MS

Provider Business Mailing Address
First Line	:	414 CLINTON PL STE 106
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-2248
Country	:	US
Telephone Number	:	708-866-6766
Fax Number	:

Provider Business Practice Location Address
First Line	:	414 CLINTON PL STE 106
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-2248
Country	:	US
Telephone Number	:	708-866-6766
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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