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HEATHER MECHELLE CLOUM M.D.
NPI 1154701076
Family Medicine in Algonquin, IL

Active since June 05, 2015PECOS EnrolledAccepts Medicare Assignment
1345 RYAN PKWY, ALGONQUIN, IL 60102(847) 658-9555(847) 658-2167 Get Directions Write a Review

NPPES record last updated: February 19, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 26, 2025, Jul 18, 2024, Nov 29, 2021 and 1 more (4 updates tracked since 2021).

About Heather Mechelle Cloum M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHER MECHELLE CLOUM M.D. (NPI 1154701076) is an individual family medicine provider in Algonquin, Illinois, licensed in Illinois (036173797) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Advocate Sherman Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1154701076
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameHEATHER MECHELLE CLOUMCredential: M.D.
Location Address1345 RYAN PKWYAlgonquin, IL 60102-4530
Mailing Address29373 Network PlChicago, IL 60673-1296 · (847) 390-5900
Phone(847) 658-9555
Fax(847) 658-2167
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJune 5, 2015
Last NPPES UpdateFebruary 19, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2026
✔ NPI 1154701076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IL · 036173797✔ Licensed in WI · 73987-20
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1345 RYAN PKWY, Algonquin, IL 60102
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Other Names 1

Former Name (1)Mira Divyeshbhai Kakadia

Secondary Practice Locations 2

Location 1W3985 County Road NnElkhorn, WI 53121-4337 · Phone (262) 741-2121
Location 2875 S Route 31Crystal Lake, IL 60014-8190 · Phone (779) 220-5500

Other Identifiers 1

Medicaid100138777WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Heather Mechelle Cloum M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406160456
PECOS Enrollment IDI20250228002731
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Heather Cloum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lutheran General Hospital
23 mi
Cardiovascular Disease
1775 DEMPSTER ST
Park Ridge, IL 60068
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Advocate Health And Hospitals Corporation
  • 4,870 clinicians in this Medicare group
NPI 1801809306 (847) 723-2210
Mercy Health System Corporation
53 mi
Multi-Specialty
580 N WASHINGTON ST
Janesville, WI 53548
  • Reassigned Medicare billing, Illinois enrollment
  • 671 clinicians in this Medicare group
NPI 1598718603 (608) 741-7630

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
162 services46 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
143 services96 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
82 services67 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
63 services56 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
51 services51 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
27 services26 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Sherman Hospital

Acute Care Hospitals · Elgin, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140030
Location1425 North Randall RoadElgin, IL 60123 · Kane County
Emergency services Birthing friendly

Mercy Health System Corp

Acute Care Hospitals · Janesville, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520066
Location1000 Mineral Point AveJanesville, WI 53548 · Rock County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAMEENA JAWED M.D.
Family Medicine
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
DR. MARIA JISNA KURUPPATH MD
Family Medicine
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
ALLZ FAMILY PRACTICE PHYSICIANS, SC
Family Medicine
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
FRAAZ M SIDDIQUI APN
Nurse Practitioner
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
YELENA BALABAN FNP-BC
Nurse Practitioner (Family)
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
MS. ELVIE J LENTH PT
Physical Therapist
1345 RYAN PKWY, SUITE 2
ALGONQUIN, IL 60102
McHenry County (847) 458-5072
MRS. DAWN KOTERBSKI PA-C
Physician Assistant
1345 RYAN PKWY
ALGONQUIN, IL 60102
McHenry County (847) 658-9555
MS. KATHLEEN ELIZABETH MCNAMARA PT
Physical Therapist
1345 RYAN PKWY, SUITE 4
ALGONQUIN, IL 60102
McHenry County (847) 458-5072

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heather Cloum's NPI number?

The NPI number for Heather Cloum is 1154701076. It was assigned to this individual provider in the NPPES registry on June 5, 2015. The provider is also known as Mira Divyeshbhai Kakadia.

Where is Heather Cloum located?

Heather Cloum practices at 1345 Ryan Pkwy, Algonquin, IL 60102. The listed phone number is (847) 658-9555.

What is Heather Cloum's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Heather Cloum enrolled in Medicare?

Yes. Heather Cloum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Heather Cloum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Heather Cloum reassigns Medicare benefits to 2 organizations: Lutheran General Hospital (Park Ridge, IL) and Mercy Health System Corporation (Janesville, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Heather Cloum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Heather Cloum accept?

Health plans from Oscar Health list Heather Cloum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Heather Cloum affiliated with any hospitals?

According to CMS data, Heather Cloum is affiliated with Advocate Sherman Hospital and Mercy Health System Corp.

When was this NPI record last updated?

The NPPES record for Heather Cloum was last updated on February 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.