Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1821054271

Anatomic Pathology & Clinical Pathology Physician

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 039209 (MI). The NPI Number for Unknown Individual is 1821054271

Main info

Organization

Inactive

59 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1821054271

Phone

(248) 338-5320

Address

1917 RELIABLE PARKWAY

Deactivation Date

1 November 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8107337741

Graduation Year

1967 (59 years ago)

PAC ID

8921995853

Group Practice PAC ID

2365419454

Professional Enrollment ID

I20040303001240

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

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Provider Addresses for Unknown Individual

1917 RELIABLE PARKWAY
CHICAGO, IL 60686
Phone: (248) 338-5320
Fax: (248) 338-5636
Type: Mailing
McLaren Oakland, 50, North Perry Street, Downtown Pontiac, Pontiac, Oakland County, Michigan, 48342, United States
PONTIAC, MI 48342
Phone: (248) 338-5000
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 60686)

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Provider's Procedures

Unknown Individual performs procedures in Anatomic Pathology & Clinical Pathology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PATHOLOGY	MI	88342	Tissue or cell analysis by immunologic technique	247	226

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: 2365419454View full group profile

Name	Specialty	State
DOINA DAVID (MD)	-	MI
DR. DAVID A WIESE (M.D.)	P A T H O L O G Y	MI
DR. PETER S NG (M.D.)	-	MI
DR. KHUSHI SWEETY LOKESH NAGORI (MBBS)	-	MI
MEHBOOB MOHAMMED SARLIQUE FATTEH (MD)	-	MI
MONROE H ADAMS (DO)	-	MI
DR. DENNIS WAYNE SPENDER (MD)	-	MI
MING CAO (MD)	-	MI
MICHAEL PATRICK BARNA (M.D.)	-	MI
Unknown Individual	-	MI

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1821054271 for Unknown Individual, then check state licensing separately.

What dates should I check for Unknown Individual's activity?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Anatomic Pathology & Clinical Pathology Physician in this dataset. Clinical services aligned with this taxonomy classification.

What address line appears for Unknown Individual?

Unknown Individual's geographic hint is Chicago, Illinois in our summary view.

Why does Unknown Individual have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.