River District Physician Practices – Family Medicine Physician, NPI 1093823197
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for River District Physician Practices
2922 SOLUTION CENTER
CHICAGO, IL 606770001
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Mailing
28000 DEQUINDRE RD
WARREN, MI 480922468
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Mailing
43800, Garfield Road, Clinton Township, Macomb County, Michigan, 48038, United States
SUITE 200
CLINTON TOWNSHIP, MI 480381136
Phone: (586) 228-4635
Fax: (586) 228-4520
Type: Mailing
31505, 32 Mile Road, Richmond Township, Macomb County, Michigan, 48062, United States
RICHMOND, MI 48062
Phone: (586) 727-5788
Fax: (586) 727-6031
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.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20040203000465 | O | Clinic/Group Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 60677)
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