Individual provider Active NPI

Jessica Heck, PT

  • General Acute Care Hospital
  • Dekalb, IL
National Provider Identifier
1447703681
Registry record updated Jul 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
070.017396 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 754-1182
NPI assigned
Jul 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 070.017396 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 754-1182

Other names 1

  • Ms. Jessica Anne Berg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.017396ILMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469318400000",
    "number": "1447703681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-754-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-754-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2016-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "070.017396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BERG",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.