Unknown Individual – Family Medicine Physician, NPI 1578535704
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
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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
| Company | Amount |
|---|---|
| Abbott Laboratories | $100 |
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.
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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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97610 | Therapy procedure using ultrasound | 1,293 | 132 | $0 |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 46 | 46 | $0 |
Insurance plans in this area (ZIP 60126)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IL | 11042 | Removal of skin and tissue first 20 sq cm or less | 314 | 128 |
Group practice members
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