Individual provider Active NPI

Alan B Hefner, M.D.

  • Ophthalmology Physician
  • St Charles, IL
National Provider Identifier
1962561282
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
40W330 Lafox Rd
St Charles, IL 60175-6515
Phone
(630) 584-9850
Fax
(630) 584-1523
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

40W330 Lafox Rd
St Charles, IL 60175-6515

Mailing address

40W330 Lafox Rd
St Charles, IL 60175-6515
Phone (630) 584-9850

Other identifiers 3

IdentifierTypeStateIssuer
1129551OtherILUNITED HEALTHCARE
36047324MedicaidIL
4519570OtherILBCBS

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
I20040214000033 IL Practitioner - Ophthalmology 4284528738 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036047324ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Ophthalmology Ophthalmology CurrentSince Jan 1, 1989 Accepting new patients
Fox Valley Ophthalmology Ophthalmology Past Accepting new patients

Locations

750 Fletcher Dr
Ste 106
Elgin, IL 60123
Phone (847) 695-0499

40W330 Lafox Rd
St Charles, IL 60175
Phone (630) 584-9850

40W330 Lafox Rd
Unit A
St Charles, IL 60175
Phone (630) 584-9850

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1962561282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40W330 LAFOX RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756515",
            "telephone_number": "630-584-9850",
            "fax_number": "630-584-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40W330 LAFOX RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756515",
            "telephone_number": "630-584-9850",
            "fax_number": "630-584-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "ALAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1129551",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36047324",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4519570",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.