Organization Active NPI

Heather Medical Associates

  • Internal Medicine Physician
  • Hazel Crest, IL
National Provider Identifier
1912912452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEATHER MEDICAL ASSOCIATES
Practice address
3330 W 177TH St
Suite 1a
Hazel Crest, IL 60429-2184
Phone
(708) 799-1100
Fax
(708) 799-8343
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Wilk, MD
Title
President
Phone
(708) 799-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3330 W 177TH St
Suite 1a
Hazel Crest, IL 60429-2184

Mailing address

3330 W 177TH St
Suite 1a
Hazel Crest, IL 60429-2184
Phone (708) 799-1100

National Provider Directory

National Provider Directory

Locations

17850 Kedzie Ave
Ste 1100
Hazel Crest, IL 60429
Phone (708) 799-1100

3330 W 177th St
Ste 1C
Hazel Crest, IL 60429
Phone (708) 799-1144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912912452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 1A",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-1100",
            "fax_number": "708-799-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 1A",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-1100",
            "fax_number": "708-799-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-799-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.