Provider Demographics
NPI:1841896644
Name:COTTINI, HEATHER ROSE (NP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ROSE
Last Name:COTTINI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ROSE
Other - Last Name:GABLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:244 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4647
Mailing Address - Country:US
Mailing Address - Phone:630-629-6298
Mailing Address - Fax:630-599-7149
Practice Address - Street 1:244 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4647
Practice Address - Country:US
Practice Address - Phone:312-500-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily