Unknown Individual – Orthopaedic Surgery Physician, NPI 1710974472

Unknown Individual is a healthcare provider. based in Oak lawn, Illinois. specializing in Orthopaedic Surgery Physician. They hold a License No. 036055747 (IL). The NPI Number for Unknown Individual is 1710974472

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710974472
Phone
(708) 423-8440
Address
5540 W 111TH ST
Deactivation Date
3 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
5193811248
Group Practice PAC ID
4183529456
Professional Enrollment ID
I20071019000488

Contacts

Secure Messaging
jmcclellan214219@Direct.FranciscanAlliance.org
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

  • 5540, West 111th Street, Oak Lawn, Worth Township, Cook County, Illinois, 60482, United States

    OAK LAWN, IL 604535574

    Phone: (708) 423-8440

    Fax: (708) 658-2962

    Type: Mailing

  • 20201 Crawford Ave Ste 1400

    Olympia Fields, IL 604611010

    Phone: (708) 679-2310

    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 60453)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYIL27447Repair of knee joint1817
ORTHOPEDIC SURGERYIL73110X-ray of wrist, minimum of 3 views1711
ORTHOPEDIC SURGERYIL73562X-ray of knee, 3 views9864

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: 4183529456View full group profile

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 1710974472.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Oak Lawn, Illinois. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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