Unknown Individual – Psychiatry Physician, NPI 1093852410

Unknown Individual is a healthcare provider. based in Lincolnshire, Illinois. specializing in PSYCHIATRY. They hold a License No. 036-062187 (IL). The NPI Number for Unknown Individual is 1093852410

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093852410
Phone
(847) 480-1346
Address
250 PARKWAY DRIVE
Deactivation Date
15 December 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
8473778800
Graduation Year
1978 (48 years ago)
PAC ID
0244210268
Group Practice PAC ID
7214838861
Professional Enrollment ID
I20040723001108
Address ID
IL600481052LI18698RDXX400
Telehealth
Yes
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

1,367 PSYCHIATRY in IL

Provider Addresses for Unknown Individual

  • 250 PARKWAY DRIVE

    STE 150 #AT107

    LINCOLNSHIRE, IL 60069

    Phone: (847) 480-1346

    Fax: (224) 545-5075

    Type: Location

  • Shermer Road, Northbrook Park, Northbrook, Cook County, Illinois, 60062, United States

    SUITE 208

    NORTHBROOK, IL 600624500

    Phone: (847) 480-1346

    Fax: (847) 480-1348

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $57.

Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.

Last reported payment date: 2024-03-18 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($28).

Total Amount

$57

General + Research + Ownership

Payments

2

Total payment records

General Amount

$57

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-18

Latest reported date

Top Companies

Largest payers in this snapshot

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 60069)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214838861View full group profile
NameSpecialtyState
Nurse PractitionerIL
-IL
-IL
Nurse PractitionerFL
Family PracticeIL
Clinical Social WorkerIL
Internal MedicineIL
Family PracticeIL
Mental Health CounselorIL
-WI

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1093852410 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Lincolnshire, Illinois because that is what the record indicates for Unknown Individual.
What if Lincolnshire, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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