Individual provider Active NPI

Douglas John Hardekopf, DNP

  • Certified Registered Nurse Anesthetist
  • Elk Grove Village, IL
National Provider Identifier
1326895749
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209029649 Issued in IL
Practice address
800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone
(847) 437-5500
NPI assigned
May 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209029649 IL Primary
Registered Nurse 163W00000X 041417818 IL

Addresses

Primary practice location

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Mailing address

394 E Tall Oaks LN
Itasca, IL 60143-2818
Phone (630) 802-9351

Other practice location 1

1555 N Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 843-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910003866 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446790067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Baylor College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Practice addresses (Care Compare)

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041417818ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 27, 2024 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Organizations & group practices 1

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 1

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": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1326895749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 E TALL OAKS LN",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432818",
            "telephone_number": "630-802-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-437-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 N Barrington Rd",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691019",
            "country_code": "US",
            "telephone_number": "847-843-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDEKOPF",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209029649",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041417818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.