UCM MEDICAL GROUP SUB, LLC – Family Medicine Physician, NPI 1467442293
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for UCM MEDICAL GROUP SUB, LLC
71, West 156th Street, Harvey, Thornton Township, Cook County, Illinois, 60426, United States
5TH FLOOR
HARVEY, IL 604264260
Phone: (708) 915-6353
Fax: (708) 915-2706
Type: Location
27702 NETWORK PL
CHICAGO, IL 606731277
Phone: (708) 862-7674
Fax: (708) 862-1781
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: 2026-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (769 days ago).
Enrollment records
22
Earliest due date
2024-04-30
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 |
|---|---|---|---|---|
| O20041026000077 | O | Clinic/Group Practice | IL | 2024-04-30 |
| O20130506000105 | O | Clinic/Group Practice | IN | 2026-07-31 |
| O20241127002402 | O | Clinic/Group Practice | OH | TBD |
| O20241203000460 | O | Clinic/Group Practice | NY | TBD |
| O20241204004079 | O | Clinic/Group Practice | WA | TBD |
| O20241204004507 | O | Clinic/Group Practice | LA | TBD |
| O20241204004554 | O | Clinic/Group Practice | CO | TBD |
| O20241211004292 | O | Clinic/Group Practice | MI | TBD |
| O20241216001249 | O | Clinic/Group Practice | MS | TBD |
| O20241218002419 | O | Clinic/Group Practice | UT | TBD |
| O20241223003308 | O | Clinic/Group Practice | MD | TBD |
| O20241227000966 | O | Clinic/Group Practice | TN | TBD |
| O20250110002865 | O | Clinic/Group Practice | TX | TBD |
| O20250217000381 | O | Clinic/Group Practice | SC | TBD |
| O20250301000151 | O | Clinic/Group Practice | IA | TBD |
| O20250303000923 | O | Clinic/Group Practice | VA | TBD |
| O20250304000784 | O | Clinic/Group Practice | NC | TBD |
| O20260113001194 | O | Clinic/Group Practice | FL | TBD |
| O20260203000914 | O | Clinic/Group Practice | NV | TBD |
| O20260220000100 | O | Clinic/Group Practice | WI | TBD |
| O20260225001694 | O | Clinic/Group Practice | MN | TBD |
| O20260312000791 | O | Clinic/Group Practice | AZ | TBD |
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 60426)
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