Individual provider Active NPI

Timothy Dale Heilenbach, MD

  • Emergency Medicine Physician
  • Westmont, IL
National Provider Identifier
1679634844
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-084724 Issued in IL
Practice address
303 W Ogden Ave
Westmont, IL 60559-1419
Phone
(888) 693-6437
Fax
(630) 432-6660
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-084724 IL Primary

Addresses

Primary practice location

303 W Ogden Ave
Westmont, IL 60559-1419

Mailing address

Pob PO Box 713260
Chicago, IL 60677-0001
Phone (630) 469-9200

Other practice location 1

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201
Phone (847) 570-2114

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theilenbach266763@dulyhealthandcare.direct-ci.com Direct

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
I20050909000521 IL Practitioner - Emergency Medicine 3375575475 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northwestern University Feinberg Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-084724ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Emergency Medicine CurrentSince Jan 1, 2000 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 1, 2000 Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 1, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 1, 2024 Accepting new patients
Emergency Healthcare Physicians, LTD. Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

23139 Network Pl
Chicago, IL 60673

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

9532 Eagle Way
Chicago, IL 60678

740 Waukegan Rd
Ste 300
Deerfield, IL 60015
Phone (847) 914-0601

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

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

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Rm 5303
Evanston, IL 60201
Phone (847) 570-2540

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

830 W End Ct
Ste 500
Vernon Hills, IL 60061
Phone (847) 522-8900

303 W Ogden Ave
Westmont, IL 60559
Phone (630) 435-6107

Interoperability endpoints

  • Direct secure messaging: timothy.heilenbach.1@22134.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1679634844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591419",
            "telephone_number": "888-693-6437",
            "fax_number": "630-432-6660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Evanston Hospital",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60201",
            "country_code": "US",
            "telephone_number": "847-570-2114",
            "fax_number": "847-570-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEILENBACH",
        "first_name": "TIMOTHY",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-084724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theilenbach266763@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "303 W Ogden Ave",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605591419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.