Unknown Individual – Diagnostic Neuroimaging (Psychiatry & Neurology) Physician, NPI 1093757080

Unknown Individual is a healthcare provider. based in Wheeling, Illinois. specializing in Diagnostic Neuroimaging (Psychiatry & Neurology) Physician. They hold a License No. 3639168 (IL). The NPI Number for Unknown Individual is 1093757080

Main info

Organization
Inactive
63 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093757080
Phone
(224) 676-0547
Address
350 E DUNDEE RD
Deactivation Date
8 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1963 (63 years ago)
PAC ID
7517960321
Professional Enrollment ID
I20060817000218
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 350, East Dundee Road, Buffalo Grove, Wheeling Township, Cook County, Illinois, 60089, United States

    SUITE 315

    WHEELING, IL 600903192

    Phone: (224) 676-0547

    Fax: (224) 676-0564

    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
90837Psychotherapy, 1 hour84457$0
99214Established patient office or other outpatient visit, 30-39 minutes12325$0
90833Psychotherapy with evaluation and management visit, 30 minutes4514$0
90791Psychiatric diagnostic evaluation2020$0
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Insurance plans in this area (ZIP 60090)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1093757080.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Diagnostic Neuroimaging (Psychiatry & Neurology) Physician in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Wheeling, Illinois as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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