Unknown Individual – Vascular Surgery Physician, NPI 1184624819
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
10258 SOUTHWEST HWY STE A
CHICAGO RIDGE, IL 604151361
Phone: (708) 346-9533
Fax: (708) 499-4312
Type: Location
Music Box Theatre, 3733, North Southport Avenue, Wrigleyville, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60613, United States
CHICAGO, IL 606894992
Phone: (918) 710-3710
Fax: (918) 770-0058
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2024-06-10 • Largest payer in this snapshot: LeMaitre Vascular, Inc. ($33).
Total Amount
$77
General + Research + Ownership
Payments
5
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-10
Latest reported date
Top Companies
Largest payers in this snapshot
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93880 | Ultrasound of both sides of head and neck blood flow | 235 | 203 | $0 |
| 93922 | Ultrasound study of arm and leg arteries | 187 | 147 | $0 |
| 99221 | Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | 141 | 132 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 103 | 101 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 98 | 86 | $0 |
Insurance plans in this area (ZIP 60415)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Vascular Surgery | IL | |
| Vascular Surgery, General Surgery | IL | |
| Physician Assistant | IL | |
| Vascular Surgery | IL | |
| Vascular Surgery | CT | |
| Physician Assistant | IL |
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