Advanced Ketamine Care – Sleep Medicine (Psychiatry & Neurology) Physician, NPI 1548791452
Sleep Medicine (Psychiatry & Neurology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Advanced Ketamine Care
1550, Spring Road, Oak Brook, DuPage County, Illinois, 60523, United States
SUITE 308
OAK BROOK, IL 605231320
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Mailing
1721 MOON LAKE BLVD STE 201
HOFFMAN ESTATES, IL 601691071
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Mailing
1721 Moon Lake Blvd Ste 201
Hoffman Estates, IL 601691071
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Location
14489 John Humphrey Dr Ste 202
Orland Park, IL 604622692
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Location
566 W Lake St Ste 200
Chicago, IL 606611413
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Location
1284 Rickert Dr Ste 200
Naperville, IL 605400949
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Location
8 S Michigan Ave Ste 1505
Chicago, IL 606033364
Phone: (630) 607-0387
Fax: (630) 385-0290
Type: Location
1200 HARGER RD STE 200
OAK BROOK, IL 605231816
Phone: (630) 607-0387
Fax: (630) 385-0290
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-05-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20230522002513 | O | Clinic/Group Practice | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 60523)
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