Unknown Individual – Internal Medicine Physician, NPI 1538119300

Unknown Individual is a healthcare provider. based in Woodstock, Illinois. specializing in Internal Medicine Physician. They hold a License No. 036093917 (IL). The NPI Number for Unknown Individual is 1538119300

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1538119300
Phone
(815) 338-6600
Address
3707 DOTY RD STE D
Deactivation Date
29 January 2026

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8153386600
Graduation Year
1994 (32 years ago)
PAC ID
8628110442
Group Practice PAC ID
5890696231
Professional Enrollment ID
I20100116000141
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

Provider Addresses for Unknown Individual

  • 3707 DOTY RD STE D

    WOODSTOCK, IL 60098

    Phone: (815) 338-6600

    Fax: (815) 206-1086

    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
99214Established patient office or other outpatient visit, 30-39 minutes523379$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes410136$0
99497Advance care planning, first 30 minutes362362$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit337337$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes279157$0
View full utilization report →

Insurance plans in this area (ZIP 60098)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEIL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report1818

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: 5890696231View full group profile
NameSpecialtyState
General SurgeryIL
Vascular SurgeryIL
-IL
Family PracticeIL
Nurse PractitionerIL
-IL
Family PracticeIL
Physical Medicine And RehabilitationCO
-IL
Hospitalist, Family PracticeIL

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1538119300.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Woodstock, Illinois for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1538119300. Always confirm identity and privileges with the practice and licensing boards.

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