Unknown Individual – Gastroenterology Physician, NPI 1508802810

Gastroenterology Physician

Unknown Individual is a healthcare provider. based in Lake barrington, Illinois. specializing in Gastroenterology Physician. They hold a License No. 036058537 (IL). The NPI Number for Unknown Individual is 1508802810

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1508802810

Phone

(847) 382-4410

Address

22285 N PEPPER RD

Deactivation Date

2 October 2025

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

Pepper Road, Lake Barrington, Cuba, Lake County, Illinois, 60010, United States
SUITE 311
LAKE BARRINGTON, IL 600102538
Phone: (847) 382-4410
Fax: (847) 382-4451
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-11-05 • Largest payer in this snapshot: ORPHALAN INC ($16).

Total Amount

$16

General + Research + Ownership

Payments

Total payment records

General Amount

$16

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2024-11-05

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
ORPHALAN INC	$16

View all Open Payments →|Open Payments Risk Radar →

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 60010)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?

NPI numbers are unique to each provider or organization — Unknown Individual uses 1508802810.

What dates should I check for Unknown Individual's activity?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Gastroenterology Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Lake Barrington, Illinois may find Unknown Individual in results; validate coverage separately.

Why does Unknown Individual have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.