Unknown Individual – Urology Physician, NPI 1104933217

Unknown Individual is a healthcare provider. based in Westmont, Illinois. specializing in Urology Physician. They hold a License No. 036056451 (IL). The NPI Number for Unknown Individual is 1104933217

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1104933217
Phone
(630) 789-2550
Address
777 OAKMONT LN
Deactivation Date
15 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
5193716785
Professional Enrollment ID
I20040521000723

Contacts

Secure Messaging
prooney5954@ce-direct.presencehealth.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 777, Oakmont Lane, Westmont, DuPage County, Illinois, 60559, United States

    SUITE 1600

    WESTMONT, IL 605595511

    Phone: (630) 789-2550

    Type: Mailing

  • 2913 N Commonwealth Ave Fl 5

    Chicago, IL 606576211

    Phone: (773) 665-3080

    Type: Location

  • 9701, Knox Avenue, Skokie, Niles Township, Cook County, Illinois, 60076, United States

    SUITE 103

    SKOKIE, IL 600761256

    Phone: (847) 674-5828

    Fax: (847) 933-6044

    Type: Location

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.

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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.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60559)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1104933217.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Urology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Westmont, Illinois may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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