NPIMap

Organization Active NPI

Heartland Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Bloomington, IL
National Provider Identifier
1780870733
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-078726 Issued in IL
Legal business name
HEARTLAND EMERGENCY SPECIALISTS, LLC
Practice address
2200 E Washington St
Bloomington, IL 61701-4364
Phone
(309) 662-3311
NPI assigned
Sep 23, 2007
Last updated
Jul 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Richard Disselkoen Castillo, MD
Title
Treasurer
Phone
(888) 437-0911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 036-078726 IL Primary

Addresses

Primary practice location

2200 E Washington St
Bloomington, IL 61701-4364

Mailing address

2538 Momentum PL
Chicago, IL 60689-0001
Phone (616) 975-1845

Other identifiers 2

IdentifierTypeStateIssuer
DG3753OtherRAILROAD MEDICARE
05732147OtherILBCBS

Other names 1

  • HES, LLC Other name

National Provider Directory

National Provider Directory

Locations

2538 Momentum Pl
Chicago, IL 60689

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1780870733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606890001",
            "telephone_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E WASHINGTON ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014364",
            "telephone_number": "309-662-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND EMERGENCY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-23",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "DISSELKOEN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "888-437-0911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-078726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG3753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05732147",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HES, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.