Unknown Individual – Diagnostic Radiology Physician, NPI 1366487399

Unknown Individual is a healthcare provider. based in Joliet, Illinois. specializing in Diagnostic Radiology Physician. They hold a License No. 036-062091 (IL). The NPI Number for Unknown Individual is 1366487399

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366487399
Phone
(815) 723-9351
Address
1200 MAPLE RD
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
3126337292
Graduation Year
1968 (58 years ago)
PAC ID
6103919576
Group Practice PAC ID
2860398088
Professional Enrollment ID
I20070831000098
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1200, Maple Road, East Joliet, Joliet, Will County, Illinois, 60432, United States

    SUITE 3309

    JOLIET, IL 604321439

    Phone: (815) 723-9351

    Fax: (815) 723-9823

    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)

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
76770Complete ultrasound scan behind abdominal cavity6358$0
93975Complete ultrasound of abdomen and pelvis artery and vein blood flow6054$0
76700Complete ultrasound scan of abdomen4343$0
73630X-ray of foot, minimum of 3 views3126$0
72040X-ray of upper spine, 2-3 views2423$0
View full utilization report →

Insurance plans in this area (ZIP 60432)

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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: 2860398088View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology)MA
-IL
-IL
O B S T E T R I C S/ G Y N E C O L O G YIL
-IL
-IL
-IL
A N E S T H E S I O L O G YIL
Physician AssistantIL

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1366487399 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Joliet, Illinois in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."