Active NPI
Pamela Heady, MT
- Specialist
- Bolingbrook, IL
National Provider Identifier
1407027360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 303 Quadrangle Dr
Bolingbrook, IL 60440-3409 - Phone
- (630) 771-1070
- Fax
- (630) 771-1030
- NPI assigned
- Mar 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Primary |
Addresses
Primary practice location
303 Quadrangle Dr
Bolingbrook, IL 60440-3409
Mailing address
5133 Main Street
#2
Downers Grove, IL 60515
Phone (815) 404-4733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2252100000X | Other | IL | MASSAGE THERAPY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.008268 | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1407027360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5133 MAIN STREET",
"address_2": "#2",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "60515",
"telephone_number": "815-404-4733",
"fax_number": "630-771-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 QUADRANGLE DR",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604403409",
"telephone_number": "630-771-1070",
"fax_number": "630-771-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEADY",
"first_name": "PAMELA",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPY",
"identifier": "2252100000X",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.