Individual provider Active NPI

Christine C Hepperlen, NP

  • Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1316017007
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-003490 Issued in IL
Practice address
750 E Terra Cotta Ave Ste B
Crystal Lake, IL 60014-3621
Phone
(815) 356-2323
Fax
(815) 455-8130
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-003490 IL Primary

Addresses

Primary practice location

750 E Terra Cotta Ave Ste B
Crystal Lake, IL 60014-3621

Mailing address

750 E Terra Cotta Ave Ste B
Crystal Lake, IL 60014-3621
Phone (815) 356-2323

Other practice location 1

3707 Doty Rd Ste B
Woodstock, IL 60098-7530
Phone (815) 356-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051110000985 IL Practitioner - Nurse Practitioner 8527086206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

750 E Terra Cotta Ave
Suite B
Crystal Lake, IL 60014-3621
Phone (815) 356-2323

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-003490ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 7, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 9, 2006 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 7, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 9, 2006 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

750 E Terra Cotta Ave
Ste B
Crystal Lake, IL 60014
Phone (815) 356-2323

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

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

3707 Doty Rd
Ste B
Woodstock, IL 60098
Phone (815) 206-5540

2000 Lake Ave
Woodstock, IL 60098
Phone (815) 337-4116

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1316017007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-356-2323",
            "fax_number": "815-455-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-356-2323",
            "fax_number": "815-455-8130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3707 Doty Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987530",
            "country_code": "US",
            "telephone_number": "815-356-2323",
            "fax_number": "815-206-2823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEPPERLEN",
        "first_name": "CHRISTINE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-003490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.