Unknown Individual – Diagnostic Radiology Physician, NPI 1073846804

Unknown Individual is a healthcare provider. based in Chicago, Illinois. specializing in Diagnostic Radiology Physician. They hold a License No. 02527383 (IL). The NPI Number for Unknown Individual is 1073846804

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1073846804
Phone
(773) 631-5900
Address
5795 N ELSTON AVE
Deactivation Date
3 May 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 5795, North Elston Avenue, Jefferson Park, Chicago, Jefferson Township, Cook County, Illinois, 60646, United States

    CHICAGO, IL 606465545

    Phone: (773) 631-5900

    Fax: (773) 631-5901

    Type: Mailing

  • 2nd Avenue, Rock Falls, Whiteside County, Illinois, 61071, United States

    ROCK FALLS, IL 610711275

    Phone: (815) 622-0900

    Fax: (773) 631-5901

    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.

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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.

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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 60646)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1073846804?
NPI 1073846804 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is Unknown Individual registered?
Use Chicago, Illinois as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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