Healthcare Provider Details

I. General information

NPI: 1346107356
Provider Name (Legal Business Name): ALYSSA PIPKIN HEIMBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 S WASHINGTON ST
NAPERVILLE IL
60565-1368
US

IV. Provider business mailing address

9500 BORMET DR STE 304
MOKENA IL
60448-8399
US

V. Phone/Fax

Practice location:
  • Phone: 331-373-1038
  • Fax:
Mailing address:
  • Phone: 815-469-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.016945
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: