Individual provider Active NPI

Emma Hogaboom

  • Physical Therapist
  • Park Ridge, IL
National Provider Identifier
1659992964
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024360 Issued in IL
Practice address
1775 Dempster St
Park Ridge, IL 60068-1143
Phone
(847) 723-4532
NPI assigned
Apr 28, 2020
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070024360 IL Primary

Addresses

Primary practice location

1775 Dempster St
Park Ridge, IL 60068-1143

Mailing address

1034 E Marion St
Arlington Heights, IL 60004-5071

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ehogaboom249578@direct.myadvocateaurora.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201204002102 IL Practitioner - Physical Therapist in Private Practice 3870904345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070024360ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Oct 1, 2020 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1675 W Dempster St
Fl 3
Park Ridge, IL 60068
Phone (847) 318-9330

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

Interoperability endpoints

  • Direct secure messaging: ehogaboom249578@direct.myadvocateaurora.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1659992964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 E MARION ST",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600045071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGABOOM",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehogaboom249578@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.