FAMILY MEDICINE SPECIALISTS, INCORPORATED – Family Medicine Physician, NPI 1063406601
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for FAMILY MEDICINE SPECIALISTS, INCORPORATED
Family Medicine, 431, West Liberty Street, Wauconda, Cuba, Lake County, Illinois, 60084, United States
WAUCONDA, IL 600842452
Phone: (847) 526-2151
Fax: (847) 526-2017
Type: Location
Wauconda Post Office, 539, West Liberty Street, Wauconda, Cuba, Lake County, Illinois, 60084, United States
WAUCONDA, IL 600846037
Phone: (847) 526-2151
Fax: (847) 526-2017
Type: Mailing
425 Lake St
Antioch, IL 600021464
Phone: (847) 395-2627
Fax: (847) 395-2615
Type: Location
909 Belvidere Rd
Waukegan, IL 600856313
Phone: (847) 244-4995
Fax: (847) 244-5099
Type: Location
9700 N Main St
Richmond, IL 600717716
Phone: (815) 678-4181
Fax: (815) 678-4184
Type: Location
431 W Liberty St
Wauconda, IL 600842452
Phone: (847) 526-2151
Fax: (847) 526-2017
Type: Location
604 W LIBERTY ST
WAUCONDA, IL 600843479
Phone: (847) 526-2151
Fax: (847) 526-2017
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-04-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (830 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040422001425 | O | Clinic/Group Practice | IL | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 60084)
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