Provider Demographics
NPI:1699214049
Name:MAY, HEATHER C (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:C
Last Name:MAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 BEDFORD LN
Mailing Address - Street 2:
Mailing Address - City:VOLO
Mailing Address - State:IL
Mailing Address - Zip Code:60073-8170
Mailing Address - Country:US
Mailing Address - Phone:847-212-9503
Mailing Address - Fax:
Practice Address - Street 1:1170 E BELVIDERE RD STE 212
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2034
Practice Address - Country:US
Practice Address - Phone:847-543-6814
Practice Address - Fax:847-543-0787
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily