HEIDI KATHLEEN HYNES NUTTALL (NPI# 1649442849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649442849 |
| Entity Type | Individual |
| Full Name | HEIDI KATHLEEN HYNES NUTTALL |
| Credential | PA-C |
| Practice Address |
400 Kennedy Dr Ste 100 Bradley IL 60915 |
| Practice Telephone | 8159288050 |
| Mailing Telephone | 8159288050 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2011-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085003195 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
400 KENNEDY DR STE 100 |
| City | BRADLEY |
| State | IL |
| Zip Code | 60915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1679826309 | Heather Sevier | Specialist/Technologist | 328 S Dearborn Ave, Bradley, IL 60915 | 2012-10-18 |
| 1013266584 | Arlene De Leon Delacruz | Physical Therapist | 400 South Kennedy Dr., Bradley, IL 60915 | 2012-08-30 |
| 1023370699 | Jessica Sorensen | Physician Assistant | 350 N Kinzie Ave, Bradley, IL 60915 | 2012-06-11 |
| 1184993164 | Debra Malone | Behavioral Analyst | 136-142 1/2 South Clinton, Bradley, IL 60915 | 2011-12-21 |
| 1376840421 | Joshua R Johnson | Physician Assistant | 400 S. Kennedy, Bradley, IL 60915 | 2011-02-24 |
| 1801192133 | Eloise Adams | Behavioral Analyst | 136 142 1/2 South Clinton, Bradley, IL 60915 | 2011-02-03 |
| 1386948685 | Rico J Hale | Behavioral Analyst | 136 142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1558665851 | Joyce A Bollhorst | Behavioral Analyst | 136-142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1538469655 | Kankakee Valley Chiropractic | Chiropractor | 300 North Kennedy Drive, Suite 2, Bradley, IL 60915 | 2010-10-22 |
| Find all providers in zip 60915 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376840421 | Joshua R Johnson | Physician Assistant | 400 S. Kennedy, Bradley, IL 60915 | 2011-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.