Unknown Individual – Physical Therapist, NPI 1215984778

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Physical Therapist. They hold a License No. 070006497 (IL). The NPI Number for Unknown Individual is 1215984778

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215984778
Phone
(312) 640-0329
Address
205 W WACKER DR
Deactivation Date
27 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8472563500
Graduation Year
1988 (38 years ago)
PAC ID
6204849474
Group Practice PAC ID
2567372931
Professional Enrollment ID
I20060711000432
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

  • Engineering Building, 205, West Upper Wacker Drive, Loop, Chicago, South Chicago Township, Cook County, Illinois, 60606, United States

    SUITE 1020

    CHICAGO, IL 606061216

    Phone: (312) 640-0329

    Type: Mailing

  • 501, Thornhill Drive, Carol Stream, DuPage County, Illinois, 60188, United States

    UNIT B

    CAROL STREAM, IL 601882793

    Phone: (630) 653-1918

    Fax: (630) 653-1928

    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.

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.

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

Insurance plans in this area (ZIP 60606)

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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: 2567372931View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1215984778 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Chicago, Illinois for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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