Individual provider Active NPI

Heather Rose Krusemark, NP

  • Acute Care Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1861014318
Registry record updated Dec 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209021094 Issued in IL
Practice address
1425 N Randall Rd
Elgin, IL 60123-2300
Phone
(847) 742-9800
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209021094 IL Primary

Addresses

Primary practice location

1425 N Randall Rd
Elgin, IL 60123-2300

Mailing address

111 Evergreen Dr
Frankfort, IL 60423-1508
Phone (708) 738-0497

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2
Direct Messaging Address hkrusemark279272@direct.myadvocateaurora.org 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200810000374 IL Practitioner - Nurse Practitioner 0345665279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209021094ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc CurrentSince Mar 13, 2023 Accepting new patients
Health Service Systems, Inc CurrentSince Mar 13, 2023 Accepting new patients

Locations

1640 Willow Circle Dr
Crest Hill, IL 60403
Phone (815) 740-2525

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

1890 Silver Cross Blvd
Ste 450
New Lenox, IL 60451
Phone (815) 723-4387

Interoperability endpoints

  • Direct secure messaging: hkrusemark279272@direct.myadvocateaurora.org

Organizations & group practices 2

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": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1861014318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EVERGREEN DR",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231508",
            "telephone_number": "708-738-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232300",
            "telephone_number": "847-742-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSEMARK",
        "first_name": "HEATHER",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209021094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "1425 N Randall Rd",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601232300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hkrusemark279272@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1425 N Randall Rd",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601232300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.