Unknown Individual – Emergency Medicine Physician, NPI 1700829678

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Emergency Medicine Physician. The NPI Number for Unknown Individual is 1700829678

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700829678
Phone
(630) 734-0200
Address
34404 EAGLE WAY
Deactivation Date
3 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
7737680810
Graduation Year
1978 (48 years ago)
PAC ID
6800852260
Group Practice PAC ID
1052578804
Professional Enrollment ID
I20071016000312
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 34404 EAGLE WAY

    CHICAGO, IL 606781344

    Phone: (630) 734-0200

    Type: Mailing

  • RML Specialty Hospital, 3435, West Van Buren Street, East Garfield Park, Chicago, Cook County, Illinois, 60624, United States

    CHICAGO, IL 606243312

    Phone: (773) 265-4571

    Type: Location

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 $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2023-01-13 • Largest payer in this snapshot: Becton, Dickinson and Company ($36).

Total Amount

$36

General + Research + Ownership

Payments

2

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-13

Latest reported date

Top Companies

Largest payers in this snapshot

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
99284Emergency department visit with moderate level of medical decision making11299$0
99285Emergency department visit with high level of medical decision making7166$0
View full utilization report →

Insurance plans in this area (ZIP 60678)

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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: 1052578804View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1700829678 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Chicago, Illinois.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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