Provider Demographics
NPI:1144351842
Name:HARTMANN, ELIZABETH (DEE) HEATON (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH (DEE)
Middle Name:HEATON
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E RANDOLPH ST
Mailing Address - Street 2:PROFESSIONAL SUITE 205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7329
Mailing Address - Country:US
Mailing Address - Phone:312-650-5242
Mailing Address - Fax:312-324-0577
Practice Address - Street 1:400 E RANDOLPH ST
Practice Address - Street 2:PROFESSIONAL SUITE 205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7329
Practice Address - Country:US
Practice Address - Phone:312-650-5242
Practice Address - Fax:312-324-0577
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635499OtherBCBS
IL212886Medicare ID - Type Unspecified