Individual provider Active NPI

Stanley Jay Heller, MD

  • Legal Medicine (M.D./D.O.) Physician
  • Chicago, IL
National Provider Identifier
1700196391
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal Medicine (M.D./D.O.) PhysicianTaxonomy code 209800000X
License
036-040665 Issued in IL
Practice address
150 S Wacker Drive
Suite 2600
Chicago, IL 60606
Phone
(312) 346-8700
Fax
(312) 346-5180
NPI assigned
Oct 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine (M.D./D.O.) Physician 209800000X 036-040665 IL Primary

Addresses

Primary practice location

150 S Wacker Drive
Suite 2600
Chicago, IL 60606

Mailing address

150 S Wacker Drive
Suite 2600
Chicago, IL 60606
Phone (312) 346-8700

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-040665ILMDLegal Medicine (M.D./D.O.) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1700196391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S WACKER DRIVE",
            "address_2": "SUITE 2600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "312-346-8700",
            "fax_number": "312-346-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S WACKER DRIVE",
            "address_2": "SUITE 2600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "312-346-8700",
            "fax_number": "312-346-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "STANLEY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": "036-040665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.