Unknown Individual – Cardiovascular Disease Physician, NPI 1063413094

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Cardiovascular Disease Physician. They hold a License No. 036-106878 (IL). The NPI Number for Unknown Individual is 1063413094

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063413094
Phone
(708) 786-2900
Address
3537 PAYSPHERE CIR
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1994 (32 years ago)
PAC ID
2961392808
Group Practice PAC ID
5991600405
Professional Enrollment ID
I20040316000996
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 3537 PAYSPHERE CIR

    CHICAGO, IL 60674

    Phone: (708) 786-2900

    Type: Mailing

  • South California Avenue, Brighton Park, Chicago, Cook County, Illinois, 60629, United States

    CHICAGO, IL 60608

    Phone: (773) 257-6552

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 32 Open Payments records for all available years, with a total value of $656.

Total Amount is formed as General ($656) + Research ($0) + Ownership ($0) = $656.

Last reported payment date: 2024-06-18 • Largest payer in this snapshot: Amgen Inc. ($114).

Total Amount

$656

General + Research + Ownership

Payments

32

Total payment records

General Amount

$656

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function254249$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes10445$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes6764$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6447$0
78452Nuclear medicine studies of heart muscle at rest and with stress and spect3737$0
View full utilization report →

Insurance plans in this area (ZIP 60674)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEIL78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies8181

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991600405View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology), Internal MedicineIL
Diagnostic Radiology, Interventional RadiologyIL
Radiation Oncology, Diagnostic RadiologyIL
Hematology/Oncology, Internal MedicineIL
Endocrinology, Internal MedicineIL
Internal MedicineIL
Internal Medicine, Sleep MedicineIL
-IL
P A T H O L O G YIL
General Surgery, Colorectal Surgery (Proctology)IL

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1063413094 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Chicago, Illinois; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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