Unknown Individual – Emergency Medical Services (Emergency Medicine) Physician, NPI 1578526828

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Emergency Medical Services (Emergency Medicine) Physician. They hold a License No. 4301406843 (MI). The NPI Number for Unknown Individual is 1578526828

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578526828
Phone
(616) 975-1845
Address
2537 MOMENTUM PL
Deactivation Date
1 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
6162008669
Graduation Year
1986 (40 years ago)
PAC ID
0042287468
Group Practice PAC ID
1658653860
Professional Enrollment ID
I20040916000201
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

  • 2537 MOMENTUM PL

    CHICAGO, IL 606895325

    Phone: (616) 975-1845

    Type: Mailing

  • 34405 W 12 Mile Rd Ste 173

    Farmington Hills, MI 483315605

    Phone: (248) 957-7999

    Fax: (248) 957-7997

    Type: Location

  • Northline Road, Fordville, Southgate, Wayne County, Michigan, 48195, United States

    SOUTHGATE, MI 481952446

    Phone: (734) 324-7800

    Type: Location

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 60689)

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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: 1658653860View full group profile
NameSpecialtyState
CAREY S O'DONNELL (PA)
Physician AssistantIL
MISS LISA MARIE COLE (M.D.)
Emergency MedicineMI
DR. JONATHAN REITZENSTEIN (MD)
-MI
DR. NATALIA DIPAOLA (M.D.)
-MI
JENNIFER J EKKENS (DO)
Emergency MedicineMI
SCOTT DUEMLER (MD)
Family PracticeMI
ANDREW JAMES BARD (MD)
Emergency MedicineGA
DR. JANICE DAY SUHAJDA (M.D.)
Family PracticeMI
JOBEDA SHEULY (MD)
Family PracticeMI
JAMES M DIEKEMA (PA-C)
Physician AssistantIL

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 1578526828.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Emergency Medical Services (Emergency Medicine) Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Chicago, Illinois in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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