| Edan Leigh Koopman, OT | |
|
1122 Main St, Antioch, IL 60002-1808 | |
| (847) 395-0321 | |
| (847) 395-0298 |
| Full Name | Edan Leigh Koopman |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1122 Main St, Antioch, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093943953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 056008919 (Illinois) | Primary |
| Provider Name | Northwestern Medical Faculty Foundation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
| Provider Name | Athletico Ltd |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1821085028 PECOS PAC ID: 4789602681 Enrollment ID: O20120612000342 |
| Mailing Address | Practice Location Address |
|---|---|
| Edan Leigh Koopman, OT 2122 York Rd Ste 300, Oak Brook, IL 60523-1925 Ph: (630) 575-1980 | Edan Leigh Koopman, OT 1122 Main St, Antioch, IL 60002-1808 Ph: (847) 395-0321 |
Tiffany Stella, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Depot St Ste N, Antioch, IL 60002 Phone: 847-838-8085 | |
Kelley Semens, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Depot St, Suite N, Antioch, IL 60002 Phone: 847-838-8085 | |
Megan Szczepanski, MOT, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Depot St Ste N, Antioch, IL 60002 Phone: 847-838-8085 Fax: 224-788-8121 | |
Valeri Galloway, MOT,OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Depot St, Suite F, Antioch, IL 60002 Phone: 847-838-8085 | |
Dpt Holdings Llc Occupational Therapist Medicare: Medicare Enrolled Practice Location: 417 E Il Route 173 Unit 101, Antioch, IL 60002 Phone: 800-974-4378 Fax: 630-515-1536 | |
Miss Heather Lynn Morningstar, MOT, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Depot St, Suite F, Antioch, IL 60002 Phone: 847-838-8085 Fax: 224-788-8121 |