Unknown Individual – Emergency Medicine Physician, NPI 1689675811

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Emergency Medicine Physician. They hold a License No. 036-098625 (IL). The NPI Number for Unknown Individual is 1689675811

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689675811
Phone
(630) 545-6016
Address
1860 PAYSPHERE CIR
Deactivation Date
6 February 2025

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
6302755900
Graduation Year
1996 (30 years ago)
PAC ID
3274507264
Group Practice PAC ID
6507854288
Professional Enrollment ID
I20040825000205

Contacts

Secure Messaging
tfendon251161@direct.myadvocateaurora.org
Main Contact
https://epicfhir.aurora.org/FHIR/MYAURORA/apiFHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 1860 PAYSPHERE CIR

    CHICAGO, IL 606740018

    Phone: (630) 545-6016

    Type: Mailing

  • 2100, Glenwood Avenue, Joliet, Will County, Illinois, 60435, United States

    JOLIET, IL 604355487

    Phone: (815) 999-3201

    Type: Location

  • 3815 Highland Ave

    Downers Grove, IL 605151500

    Phone: (630) 275-1160

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making272267$0
99284Emergency department visit with moderate level of medical decision making5555$0
99283Emergency department visit with low level of medical decision making1414$0
View full utilization report →

Insurance plans in this area (ZIP 60674)

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Provider's Procedures

Unknown Individual performs procedures in Emergency Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINEIL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report357350

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: 6507854288View full group profile
NameSpecialtyState
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineOK
Emergency MedicineIL
Emergency MedicineIN
Emergency Medicine, Internal MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
-IL

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1689675811.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
How should patients interpret Unknown Individual's specialty?
The extract shows Emergency Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Chicago, Illinois?
For routing, start with Chicago, Illinois for Unknown Individual, then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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