Unknown Individual – Internal Medicine Physician, NPI 1225093750

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in New lenox, Illinois. specializing in Internal Medicine Physician. They hold a License No. 036059465 (IL). The NPI Number for Unknown Individual is 1225093750

Main info

Organization

Inactive

54 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1225093750

Phone

(815) 300-1450

Address

1890 SILVER CROSS BLVD

Deactivation Date

19 December 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8157274292

Graduation Year

1972 (54 years ago)

PAC ID

0042340325

Group Practice PAC ID

2264408699

Professional Enrollment ID

I20100612000199

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

1890, Silver Cross Boulevard, New Lenox, Will County, Illinois, 60451, United States
NEW LENOX, IL 604519524
Phone: (815) 300-1450
Fax: (815) 300-4703
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)

CMS reports 5 Open Payments records for all available years, with a total value of $184.

Total Amount is formed as General ($184) + Research ($0) + Ownership ($0) = $184.

Last reported payment date: 2023-03-22 • Largest payer in this snapshot: Abbott Laboratories ($184).

Total Amount

$184

General + Research + Ownership

Payments

Total payment records

General Amount

$184

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2023-03-22

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
Abbott Laboratories	$184

View all Open Payments →|Open Payments Risk Radar →

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 60451)

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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: 2264408699View full group profile

Name	Specialty	State
RESHMA LACHMAN RELWANI (DO)	Internal Medicine	IL
MR. ABRAHAM THOMAS (MD)	Internal Medicine	IL
DIANA M BURDA (MD)	Internal Medicine	IL
STEVEN JOHN ANTONINI (MD)	Pediatric Medicine, Internal Medicine	IL
CRYSTAL D. HINES-MAYS (M.D.)	Family Practice	IL
MRS. FRANCES MARIE FLYNN (APRN)	-	IL
ROBERTO P RAMIREZ (M.D.)	Internal Medicine	IL
MARIA F COLE (DO)	Internal Medicine	IL
M GHAITH MULKI (M.D.)	Internal Medicine	IL
DR. PAUL G STRIEGEL (M.D.)	Family Practice	IL

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?

CMS-hosted NPPES data lists Unknown Individual with NPI 1225093750.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near New Lenox, Illinois may find Unknown Individual in results; validate coverage separately.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.