Unknown Individual – Podiatrist, NPI 1073512216

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Podiatrist. They hold a License No. 016003118 (IL). The NPI Number for Unknown Individual is 1073512216

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073512216
Phone
(773) 296-7160
Address
3000 N HALSTED ST
Deactivation Date
2 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732967160
Graduation Year
1980 (46 years ago)
PAC ID
7719881986
Group Practice PAC ID
4486558640
Professional Enrollment ID
I20090422000452
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

  • Illinois Masonic Medical Center, 3000, North Halsted Street, Boystown, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60657, United States

    SUITE 301

    CHICAGO, IL 606575188

    Phone: (773) 296-7160

    Fax: (773) 296-3440

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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
99213Established patient office or other outpatient visit, 20-29 minutes8055$0
99203New patient office or other outpatient visit, 30-44 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 60657)

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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: 4486558640View full group profile
NameSpecialtyState
P O D I A T R YIL
P O D I A T R YMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1073512216 — 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 healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Podiatrist. 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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