Unknown Individual – Family Nurse Practitioner, NPI 1184273633

Unknown Individual is a healthcare provider. based in Shumway, Illinois. specializing in Family Nurse Practitioner. They hold a License No. 209020234 (IL). The NPI Number for Unknown Individual is 1184273633

Main info

Organization
Inactive
7 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184273633
Phone
(217) 821-5412
Address
6598 E 1600th Ave
Deactivation Date
23 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2173472707
Graduation Year
2019 (7 years ago)
PAC ID
2769429489
Group Practice PAC ID
0446159735
Professional Enrollment ID
I20200910002621
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 6598 E 1600th Ave

    Shumway, IL 624612337

    Phone: (217) 821-5412

    Type: Location

  • Network Centre Drive, Effingham, Effingham County, Illinois, 62401, United States

    EFFINGHAM, IL 624014632

    Phone: (217) 347-2707

    Fax: (217) 347-2827

    Type: Mailing

  • 1, West Washington Street, Morocco, Newton County, Indiana, 47963, United States

    NEWTON, IL 624481249

    Phone: (618) 783-0954

    Fax: (618) 783-0958

    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.

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 62461)

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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: 0446159735View full group profile

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1184273633.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Illinois is Unknown Individual registered?
Use Shumway, Illinois as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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