PHYSICIANS IMMEDIATE CARE NORTH CHICAGO LLC – Urgent Care Clinic/Center, NPI 1205814118
Urgent Care Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PHYSICIANS IMMEDIATE CARE NORTH CHICAGO LLC
4800 W 129th St
Alsip, IL 608033016
Phone: (708) 316-2028
Fax: (708) 316-2059
Type: Location
PO BOX 500
ELLICOTTVILLE, NY 147310500
Phone:
Type: Mailing
4211, North Cicero Avenue, Grayland, Portage Park, Chicago, Jefferson Township, Cook County, Illinois, 60641, United States
SUITE 100
CHICAGO, IL 606411651
Phone: (815) 713-2738
Fax: (815) 986-4217
Type: Location
Northwest Plaza, 9701, West Higgins Road, Rosemont, Leyden Township, Cook County, Illinois, 60018, United States
SUITE 270
ROSEMONT, IL 600184703
Phone: (847) 653-0144
Fax: (815) 986-4217
Type: Mailing
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: 2004-06-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (315 days ago).
Enrollment records
1
Earliest due date
2025-07-31
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 |
|---|---|---|---|---|
| O20040626000381 | O | Clinic/Group Practice | IL | 2025-07-31 |
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 60803)
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