Unknown Individual – Retina Specialist (Ophthalmology) Physician, NPI 1538169248

Unknown Individual is a healthcare provider. based in Harvey, Illinois. specializing in Retina Specialist (Ophthalmology) Physician. They hold a License No. 036064569 (IL). The NPI Number for Unknown Individual is 1538169248

Main info

Organization
Inactive
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1538169248
Phone
(708) 596-8710
Address
71 W 156TH ST
Deactivation Date
1 November 2023

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3129425315
Graduation Year
null (2026 years ago)
PAC ID
8921911041
Group Practice PAC ID
2567411325
Professional Enrollment ID
I20080229000456

Contacts

Secure Messaging
kpacko@illret.intellechartdirect.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 71, West 156th Street, Harvey, Thornton Township, Cook County, Illinois, 60426, United States

    SUITE 400

    HARVEY, IL 604264260

    Phone: (708) 596-8710

    Fax: (708) 596-9820

    Type: Mailing

  • 11516 183RD PL STE SW

    ORLAND PARK, IL 604679471

    Phone: (708) 877-1300

    Fax: (708) 596-8719

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $33,260.

Total Amount is formed as General ($33,260) + Research ($0) + Ownership ($0) = $33,260.

Last reported payment date: 2023-06-13 • Largest payer in this snapshot: US Retina LLC ($33,260).

Total Amount

$33,260

General + Research + Ownership

Payments

2

Total payment records

General Amount

$33,260

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

1

Ownership records

Last Payment Date

2023-06-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
US Retina LLC$33,260
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 60426)

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Provider's Procedures

Unknown Individual performs procedures in Retina Specialist (Ophthalmology) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYIL92083Measurement of field of vision during daylight conditions5151
OPHTHALMOLOGYIL92134Diagnostic imaging of retina998476

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: 2567411325View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YTX
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
Ophthalmology, Internal MedicineOH
O P H T H A L M O L O G YIL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1538169248?
NPI 1538169248 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Retina Specialist (Ophthalmology) Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Illinois is Unknown Individual registered?
Use Harvey, Illinois as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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