Individual provider Active NPI

Ryan Kooperman, D.O.

  • Obstetrics & Gynecology Physician
  • Highland Park, IL
National Provider Identifier
1982043097
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.140707 Issued in IL
Practice address
767 Park Ave W Ste 2800
Highland Park, IL 60035-2400
Phone
(847) 926-6506
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.140707 IL Primary
Obstetrics & Gynecology Physician 207V00000X 125062720 IL

Addresses

Primary practice location

767 Park Ave W Ste 2800
Highland Park, IL 60035-2400

Mailing address

767 Park Ave West
Highland Park Hospital
Highland Park, IL 60035-3707
Phone (847) 432-1558

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
I20170721002470 IL Practitioner - Obstetrics/Gynecology 8921397282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Midwestern University, Chicago College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 E Rollins Rd
Round Lake Beach, IL 60073-2228
Phone (224) 364-2273

15 S McHenry Rd
Buffalo Grove, IL 60089-6705
Phone (847) 520-9424

2650 Ridge Ave
Evanston, IL 60201-1700

757 Park Ave W
Suite 2800
Highland Park, IL 60035-2557
Phone (847) 926-6500

777 Park Ave W
Highland Park, IL 60035-2433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.140707ILMDObstetrics & Gynecology Physician
125062720ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2017 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 10, 2019 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2017 Accepting new patients

Locations

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

15 S McHenry Rd
Fl 4
Buffalo Grove, IL 60089
Phone (847) 520-9424

9532 Eagle Way
Chicago, IL 60678

29373 Network Pl
Chicago, IL 60673

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
#1223
Evanston, IL 60201
Phone (847) 982-3172

757 Park Ave W
Ste 2800
Highland Park, IL 60035
Phone (847) 432-1558

767 Park Ave W
Highland Park, IL 60035
Phone (773) 759-4336

757 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3800

767 Park Ave W
Ste 240
Highland Park, IL 60035
Phone (847) 432-1558

767 Park Ave W
Ste 2800
Highland Park, IL 60035
Phone (847) 926-6506

1000 E Rollins Rd
Round Lake Beach, IL 60073
Phone (847) 367-5400

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1982043097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 PARK AVE WEST",
            "address_2": "HIGHLAND PARK HOSPITAL",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353707",
            "telephone_number": "847-432-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W STE 2800",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "847-926-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPERMAN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.140707",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125062720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.