Unknown Individual – Family Medicine Physician, NPI 1578535704

Unknown Individual is a healthcare provider. based in Elmhurst, Illinois. specializing in Family Medicine Physician. They hold a License No. 036.119654 (IL). The NPI Number for Unknown Individual is 1578535704

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578535704
Phone
(512) 573-6862
Address
401 N YORK RD STE 4
Deactivation Date
15 May 2024

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8478109095
Graduation Year
1996 (30 years ago)
PAC ID
7416937867
Group Practice PAC ID
1153505565
Professional Enrollment ID
I20111119000104
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

  • 401 N YORK RD STE 4

    ELMHURST, IL 601265510

    Phone: (512) 573-6862

    Type: Location

  • 7301 N LINCOLN AVE

    STE 183

    LINCOLNWOOD, IL 607121736

    Phone: (512) 573-6862

    Type: Mailing

  • 1627, East Hyde Park Boulevard, Hyde Park, Chicago, Hyde Park Township, Cook County, Illinois, 60615, United States

    CHICAGO, IL 606153153

    Phone: (512) 573-6862

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $100.

Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.

Last reported payment date: 2023-06-27 • Largest payer in this snapshot: Abbott Laboratories ($100).

Total Amount

$100

General + Research + Ownership

Payments

1

Total payment records

General Amount

$100

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$100
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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97610Therapy procedure using ultrasound1,293132$0
99344Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes4646$0
View full utilization report →

Insurance plans in this area (ZIP 60126)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEIL11042Removal of skin and tissue first 20 sq cm or less314128

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: 1153505565View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1578535704.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Elmhurst, Illinois. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

Similar Providers

9650 E Washington St Ste 100
NPI: 1740283803

DAVID B CESPEDES (DO)

Family Medicine Physician
172, Schiller Street, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1699775650

ASMA M AYUB (M.D.)

Family Medicine Physician
Winfield Road, Warrenville, DuPage County, Illinois, 60563, United States
NPI: 1063413326

DR. MICHAEL L KYLE (MD)

Family Medicine Physician
172, Schiller Street, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1578556544

DR. MARY C HUTTON (MD)

Family Medicine Physician
2650 RIDGE AVE # 1223
NPI: 1164415808

DR. MUNIRA M KOITA (MD)

Family Medicine Physician
205, East Butterfield Road, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1568453272

JUAN PEREZ (D.O.)

Family Medicine Physician
429, North York Street, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1659359180

OFELIA PHILLIPS (M.D.)

Family Medicine Physician
Nagpal & Arora Associates, 360, West Butterfield Road, Yorkfield, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1548240328

JOHN A BENAGES (MD)

Family Medicine Physician
172, Schiller Street, Elmhurst, DuPage County, Illinois, 60126, United States
NPI: 1679524722