Individual provider Active NPI

Heather Ann Koopmann, AU.D.

  • Audiologist
  • Glen Ellyn, IL
National Provider Identifier
1013596485
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.001829 Issued in IL
Practice address
430 Pennsylvania Ave Ste 330
Glen Ellyn, IL 60137-4464
Phone
(630) 545-7650
Fax
(630) 545-7839
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147.001829 IL Primary

Addresses

Primary practice location

430 Pennsylvania Ave Ste 330
Glen Ellyn, IL 60137-4464

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

3922 Mercy Dr
McHenry, IL 60050-3179
Phone (815) 344-4499

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hkoopmann260055@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147.001829ILMDAudiologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1013596485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 PENNSYLVANIA AVE STE 330",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374464",
            "telephone_number": "630-545-7650",
            "fax_number": "630-545-7839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3922 Mercy Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600503179",
            "country_code": "US",
            "telephone_number": "815-344-4499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOPMANN",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hkoopmann260055@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "430 Pennsylvania Ave Ste 330",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.