Unknown Individual – Emergency Medicine Physician, NPI 1083779698
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
South La Grange Road, Tinley Park, Orland Township, Cook County, Illinois, 60467, United States
SUITE 110
TINLEY PARK, IL 604877722
Phone: (708) 478-2500
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)
CMS reports 2 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-08-29 • Largest payer in this snapshot: SANOFI PASTEUR INC. ($36).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SANOFI PASTEUR INC. | $36 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 57 | 55 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 40 | 40 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 36 | 36 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 60487)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| - | IL | |
| Hospice/Palliative Care, Internal Medicine | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| Nurse Practitioner | IL | |
| Diagnostic Radiology | IL | |
| - | IL | |
| Interventional Radiology | IL | |
| Emergency Medicine | MA | |
| Certified Registered Nurse Anesthetist (Crna) | IL |
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