Unknown Individual – Surgery Physician, NPI 1104892389

Unknown Individual is a healthcare provider. based in Maywood, Illinois. specializing in Surgery Physician. They hold a License No. 36082006 (IL). The NPI Number for Unknown Individual is 1104892389

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104892389
Phone
(708) 216-9000
Address
2160 S FIRST AVE
Deactivation Date
19 June 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

Provider Addresses for Unknown Individual

  • 2160 S FIRST AVE

    EMS BLDG.

    MAYWOOD, IL 60153

    Phone: (708) 216-9000

    Fax: (708) 327-3474

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 60153)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1104892389.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Surgery Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Maywood, Illinois in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

2160, South 1st Avenue, Maywood, Proviso Township, Cook County, Illinois, 60153, United States
NPI: 1770588287

HIEU TON-THAT (MD)

Surgery Physician
2160 S. FIRST AVENUE
NPI: 1457359259

AMY D LU (MD)

Transplant Surgery Physician
PO BOX 1289
NPI: 1821098641

DR. JAMES N LAU (M.D.)

Surgery Physician
Stanford Hospital, 300, Pasteur Drive, Stanford, Palo Alto, Santa Clara County, California, 94305, United States
NPI: 1487632261

JOSEPH MUELLER (MD)

Emergency Medicine Physician
2160 S FIRST AVE
NPI: 1841279114

GILES CHRISTOPHER SIMPSON (MD)

Emergency Medicine Physician
2160 S FIRST AVE
NPI: 1316927155

ROBERT RIGGS (MD)

Emergency Medicine Physician
2160, South 1st Avenue, Maywood, Proviso Township, Cook County, Illinois, 60153, United States
NPI: 1063492817

TRAC XUAN NGHIEM (MD)

Emergency Medicine Physician
2160 S FIRST AVE
NPI: 1003896846
2160 S FIRST AVE
NPI: 1912987751