Screening result
NPI 1104878115Screened 6/4/2026, 12:33:28 AM against OIG LEIE (snapshot 2026-05-08) + state board sanctions + SAM.gov + OFAC SDN + FDA Debarment.
WATCH
Historical or low-severity record.
This NPI has a historical record — typically a reinstated exclusion or a less-severe state board action. Surface to compliance review.
Reasons (2)
- • IL medical board probation (2020-04-06)
- • IL medical board refused to renew (2018-07-30)
State board sanctions
| State / Board | Action | Date | Reinstated |
|---|---|---|---|
| IL medical | Probation | 2020-04-06 | 2023-05-26 |
| IL medical | Refused to Renew | 2018-07-30 | 2020-04-06 |
Financial transparency (Open Payments)
CMS Open Payments (Sunshine Act) data for 2023. Shows payments from pharmaceutical and device companies to this provider.
Total received
$20,526
Total records
70
Payment categories
4
| Nature of payment | Amount | Records |
|---|---|---|
| Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program | $14,250 | 5 |
| Consulting Fee | $3,120 | 2 |
| Food and Beverage | $1,736 | 55 |
| Travel and Lodging | $1,420 | 8 |
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Source + audit trail
- NPI screened
- 1104878115
- Screen timestamp
- 6/4/2026, 12:33:28 AM
- OIG LEIE snapshot
- 2026-05-08
- State boards consulted
- (none with active adapters)
- Risk band
- WATCH
- Risk score
- 20
- Matches found
- 2
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ProviderScore — Sanctions Screening Record
Record generated 6/4/2026, 12:33:28 AM
NPI 1104878115
WATCH Historical or low-severity record.
Screened 6/4/2026, 12:33:28 AM
Lists checked
| Source list | Result | Detail |
|---|---|---|
| OIG LEIE (federal exclusions) | Clear | snapshot 2026-05-08 |
| State board sanctions | FLAGGED (2) | 40 states live: AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, IL, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NV, NY, OH, OR, PA, SC, TN, TX, WA, WV, WY |
| State Medicaid exclusions | Clear | — |
| SAM.gov / GSA exclusions | Clear | — |
| OFAC SDN (Treasury) | Clear | — |
| FDA debarment | Clear | — |
Findings (2)
- IL medical board probation (2020-04-06)
- IL medical board refused to renew (2018-07-30)
Source + audit trail
| NPI screened | 1104878115 |
| Screen timestamp | 6/4/2026, 12:33:28 AM |
| OIG LEIE snapshot | 2026-05-08 |
| State boards covered | AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, IL, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NV, NY, OH, OR, PA, SC, TN, TX, WA, WV, WY |
| Risk band | WATCH |
| Risk score | 20 |
| Total matches | 2 |
This record reflects the sources and snapshot dates listed above at the time of generation. Not legal advice. ProviderScore screens exclusion/sanction lists, not primary-source license verification.
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