NPIMap

Individual provider Active NPI

Sean W.P. Koppe, M.D.

  • Hepatology Physician
  • Chicago, IL
National Provider Identifier
1073534681
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hepatology PhysicianTaxonomy code 207RI0008X
License
036111498 Issued in IL
Practice address
840 S Wood St
Clinical Sciences Building (CSB), MC/716
Chicago, IL 60612-4325
Phone
(312) 355-3558
Fax
(312) 413-2844
NPI assigned
Jul 21, 2006
Last updated
Dec 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36111498 IL
Gastroenterology Physician 207RG0100X 036111498 IL
Hepatology Physician 207RI0008X 036111498 IL Primary
Transplant Hepatology Physician 207RT0003X 036111498 IL

Addresses

Primary practice location

840 S Wood St
Clinical Sciences Building (CSB), MC/716
Chicago, IL 60612-4325

Mailing address

840 S Wood St
Clinical Sciences Building (CSB), MC/716
Chicago, IL 60612-4325
Phone (312) 355-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070723000022 IL Practitioner - Internal MedicinePractitioner - Hematology/OncologyPractitioner - GastroenterologyPractitioner - Other (Physician) 4486755352 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology, Hematology/Oncology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

676 N Saint Clair
Arkes 1725
Chicago, IL 60611-2927
Phone (312) 695-8108

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36111498ILMDInternal Medicine Physician
036111498ILMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 25, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Aug 25, 2014 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 1, 2022 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

7732 Solutions Ctr
Chicago, IL 60677

840 S Wood St
Bldg Csb
Chicago, IL 60612
Phone (312) 355-3558

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1073534681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "CLINICAL SCIENCES BUILDING (CSB), MC/716",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-355-3558",
            "fax_number": "312-413-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "CLINICAL SCIENCES BUILDING (CSB), MC/716",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-355-3558",
            "fax_number": "312-413-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPE",
        "first_name": "SEAN",
        "middle_name": "W.P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36111498",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036111498",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "IL",
            "license": "036111498",
            "primary": true
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "IL",
            "license": "036111498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.