Active NPI
Heather Ann Koopmann, AU.D.
- Audiologist
- Glen Ellyn, IL
National Provider Identifier
1013596485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147.001829
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 147.001829 | IL | MD | Audiologist |
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.