Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1093728511

Unknown Individual is a healthcare provider. based in Evanston, Illinois. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 036077429 (IL). The NPI Number for Unknown Individual is 1093728511

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093728511
Phone
(847) 570-1206
Address
2650 RIDGE AVE
Deactivation Date
26 July 2024

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
8476186150
Graduation Year
1986 (40 years ago)
PAC ID
8628042215
Group Practice PAC ID
2567441785
Professional Enrollment ID
I20070302000309
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

  • Evanston Hospital, 2650, Ridge Avenue, Evanston, Evanston Township, Cook County, Illinois, 60201, United States

    EVANSTON HOSPITAL

    EVANSTON, IL 602011718

    Phone: (847) 570-1206

    Fax: (847) 570-1248

    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
88305Pathology examination of tissue using a microscope, intermediate complexity2,456959$0
88311Preparation of tissue for examination by removing any calcium present172142$0
88341Special stained specimen slides to examine tissue, each additional procedure15049$0
88304Pathology examination of tissue using a microscope, moderately low complexity144130$0
88307Pathology examination of tissue using a microscope, moderately high complexity14383$0
View full utilization report →

Insurance plans in this area (ZIP 60201)

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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: 2567441785View full group profile
NameSpecialtyState
-IL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL
P A T H O L O G YIL

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1093728511 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Evanston, Illinois in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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Unknown Individual

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