Unknown Individual – Ophthalmology Physician, NPI 1356334379

Unknown Individual is a healthcare provider. based in Calumet city, Illinois. specializing in Ophthalmology Physician. They hold a License No. 036059986 (IL). The NPI Number for Unknown Individual is 1356334379

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356334379
Phone
(708) 891-3330
Address
1700 E WEST RD
Deactivation Date
31 July 2025

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
7088913330
Graduation Year
1969 (57 years ago)
PAC ID
5799747457
Group Practice PAC ID
3375525645
Professional Enrollment ID
I20041103001235
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

  • East West Road, River Oaks West Mall, Calumet City, Thornton Township, Cook County, Illinois, 60409, United States

    CALUMET CITY, IL 604095415

    Phone: (708) 891-3330

    Fax: (708) 891-0904

    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 9 Open Payments records for all available years, with a total value of $193.

Total Amount is formed as General ($193) + Research ($0) + Ownership ($0) = $193.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: ABBVIE INC. ($64).

Total Amount

$193

General + Research + Ownership

Payments

9

Total payment records

General Amount

$193

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

Top Companies

Largest payers in this snapshot

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92012Established patient problem focused exam of visual system713369$0
92014Established patient complete exam of visual system340326$0
92250Photography of the retina316310$0
92083Exam of visual field with extended testing274263$0
92133Imaging of optic nerve247235$0
View full utilization report →

Insurance plans in this area (ZIP 60409)

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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: 3375525645View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
O P T O M E T R YIL
-IL
-IL
O P H T H A L M O L O G YIL
O P T O M E T R YIL
-IL
O P T O M E T R YIL
O P H T H A L M O L O G YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1356334379 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Calumet City, Illinois in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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