Unknown Individual – Interventional Cardiology Physician, NPI 1356433320

Unknown Individual is a healthcare provider. based in Elgin, Illinois. specializing in Interventional Cardiology Physician. They hold a License No. 036049639 (IL). The NPI Number for Unknown Individual is 1356433320

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356433320
Phone
(847) 717-0600
Address
1975 LIN LOR LN STE 155
Deactivation Date
5 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8477170600
Graduation Year
1971 (55 years ago)
PAC ID
3375514227
Group Practice PAC ID
2860396769
Professional Enrollment ID
I20041210000169

Contacts

Secure Messaging
mriaz47990@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

  • 1975 LIN LOR LN STE 155

    ELGIN, IL 601234902

    Phone: (847) 717-0600

    Type: Location

  • 915 Center St

    Suite 2001

    Elgin, IL 601202106

    Phone: (847) 931-4200

    Fax: (847) 931-4217

    Type: Location

  • 915, Center Street, Elgin, Fayette County, Iowa, 52141, United States

    SUITE 2001

    ELGIN, IL 601202106

    Phone: (847) 931-4200

    Fax: (847) 931-4217

    Type: Mailing

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 60123)

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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: 2860396769View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1356433320.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Interventional Cardiology Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Elgin, Illinois. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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