Edan Leigh Koopman, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056008919 Issued in IL

Practice address

1122 Main St
Antioch, IL 60002-1808

Phone

(847) 395-0321

Fax

(847) 395-0298

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edan.koopman.p7@direct.athleticoltd.nextgenshare.com
• Direct secure messaging: edan.koopman.p9@direct.athleticoltd.nextgenshare.com

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

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  WI

  Medicare reassignment Care Compare group NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1093943953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021808",
            "telephone_number": "847-395-0321",
            "fax_number": "847-395-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPMAN",
        "first_name": "EDAN",
        "middle_name": "LEIGH",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly F Vepley
• Jessica J Kinzle, M.S., CCC-SLP
• Jodi L Klemm, PTA
• Barbara J Kmiec, LMT
• Lori Kokaska, LCSW
• Amanda Kosh
• Glory Kosmatka
• Kozak Orthodontics, P.C.
• Julie C Kregel, PT, DPT
• Kathleen Bleyaert Krostal, PHD

• Occupational Therapist in Antioch, IL
• Providers in Antioch, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.