Individual provider Active NPI

Heberto Z Hernandez, MD

  • Internal Medicine Physician
  • Highland Park, IL
National Provider Identifier
1366419194
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036107210 Issued in IL
Practice address
1780 Green Bay Rd Ste 202
Highland Park, IL 60035-3276
Phone
(847) 433-5864
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036107210 IL Primary

Addresses

Primary practice location

1780 Green Bay Rd Ste 202
Highland Park, IL 60035-3276

Mailing address

1954 1St St Ste 335
Highland Park, IL 60035-3104
Phone (847) 433-5864

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000134 IL Practitioner - Internal Medicine 0840258588 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Medical LTD 2 clinicians
Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

1780 Green Bay Rd
Highland Park, IL 60035-3276

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

718 Glenview Ave
Highland Park, IL 60035-2432
Phone (847) 433-1060

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Admire Home Healthcare Agency, Inc Home health agency, Skokie, IL, CCN 147818
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Warren Barr North Shore Nursing home, Highland Park, IL, CCN 145923

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
North Shore Medical, LTD Internal Medicine CurrentSince Nov 1, 2004 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 2, 2020 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

1780 Green Bay Rd
Ste 202
Highland Park, IL 60035
Phone (847) 433-5864

1954 1st St
Ste 335
Highland Park, IL 60035

767 Park Ave W
Ste 110
Highland Park, IL 60035
Phone (847) 433-1013

800 N Westmoreland Rd
Ste 201
Lake Forest, IL 60045
Phone (847) 388-0603

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Warren Barr North Shore LLCHighland Park, IL, CCN 145923 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 1, 2014
Jul 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1366419194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 1ST ST STE 335",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353104",
            "telephone_number": "847-433-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 GREEN BAY RD STE 202",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353276",
            "telephone_number": "847-433-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "HEBERTO",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036107210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.