Elizabeth Heideman, PHD

Individual provider Active NPI Clinical Neuropsychologist · Riverwoods, IL

NPI 1992137673 · NPPES record last updated May 13, 2023

Key facts

NPI
1992137673
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Neuropsychologist 103G00000X
License
071.008639 (IL)
Practice address
2610 Lake Cook Road
Suite 133
Riverwoods, IL 60015
Phone
(847) 920-7187
Fax
(847) 637-5238
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.008639ILMDClinical Neuropsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071.008639 IL Yes

Addresses

Primary practice location

2610 Lake Cook Road
Suite 133
Riverwoods, IL 60015

Mailing address

2610 Lake Cook Road
Suite 133
Riverwoods, IL 60015
Phone (847) 570-2000

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address eheideman240528@direct.northshore.org

Other providers in Riverwoods, IL

All providers in Riverwoods, IL · Clinical Neuropsychologist in Illinois

Sources for this page

Verify at the official NPI Registry.