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NPI Code Detail

MEDICARE: MRS. KATHERINE LEE HEIDT DNP, AGACNP

MEDICARE: MRS. KATHERINE LEE HEIDT DNP, AGACNP
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
1363LA2100XAcute Care Nurse Practitioner209032518IL

General Provider Information

NPI Number : 1841187366
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE LEE HEIDT DNP, AGACNP
Provider Business Mailing Address
First Line : 429 FARRINGTON DR
Second Line :
City : LINCOLNSHIRE
State : IL
Zip : 60069-2505
Country : US
Telephone Number : 847-525-4670
Fax Number :
Provider Business Practice Location Address
First Line : 1620 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3801
Country : US
Telephone Number : 312-942-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2025
Last Update Date : 06/18/2025

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