Unknown Individual – Physician Assistant, NPI 1174645568

Unknown Individual is a healthcare provider. based in Burbank, Illinois. specializing in Physician Assistant. The NPI Number for Unknown Individual is 1174645568

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174645568
Phone
(708) 424-1887
Address
5014 W 83RD ST
Deactivation Date
23 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 5014 W 83RD ST

    BURBANK, IL 604592722

    Phone: (708) 424-1887

    Type: Mailing

  • 2424 S PULASKI RD

    CHICAGO, IL 606233718

    Phone: (773) 257-8308

    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.

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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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes193129$0
99406Smoking and tobacco use intensive counseling, 4-10 minutes4633$0
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit3030$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit2929$0
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 60459)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1174645568 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Burbank?
Unknown Individual currently maps to Burbank, Illinois in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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