Provider Demographics
NPI:1982428769
Name:ACKMAN, HEATHER (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ACKMAN
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7491 N SHIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:DUNDAS
Mailing Address - State:IL
Mailing Address - Zip Code:62425-2438
Mailing Address - Country:US
Mailing Address - Phone:618-838-5740
Mailing Address - Fax:
Practice Address - Street 1:117 E MARKET ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2241
Practice Address - Country:US
Practice Address - Phone:618-392-1301
Practice Address - Fax:618-392-1302
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031012363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health