Joshua Heacock
Individual provider Active NPI Surgical Assistant · Tinley Park, IL
NPI 1689291502 · NPPES record last updated Jun 26, 2020
Key facts
- NPI
- 1689291502
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Assistant 246ZC0007X
- License
- 238000678 (IL)
- Practice address
- 16255 Harlem Ave
Tinley Park, IL 60477-1615 - Phone
- (708) 599-5000
- NPI assigned
- Jun 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238000678 | IL | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Orthopedic and Spine Care SC | Current |
Accepting new patients |
Locations
16255 Harlem Ave
Tinley Park, IL 60477
Phone (708) 599-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 238000678 | IL | Yes |
Addresses
Primary practice location
16255 Harlem Ave
Tinley Park, IL 60477-1615
Mailing address
16255 Harlem Ave
Tinley Park, IL 60477-1615
Phone (708) 599-5000
Other providers in Tinley Park, IL
- Kessy Ann Haubenreiser
- Jasmine Hawkins
- Shakaib Hayat
- Sharon Gwenell Hayes
- David Hayward
- Healing for Your Soul Therapeutic Services LLC
- Health Class 4U Inc
- Health on Earth Chiropractic and Rehabilitation, LLC
- Healthselect Ipa
- Healthy Kids,SC
All providers in Tinley Park, IL · Surgical Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.