Unknown Individual – Podiatrist, NPI 1235240250

Unknown Individual is a healthcare provider. based in Bloomington, Illinois. specializing in Podiatrist. They hold a License No. 016004533 (IL). The NPI Number for Unknown Individual is 1235240250

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235240250
Phone
(309) 663-2306
Address
2708 MCGRAW DR
Deactivation Date
1 July 2021

Doctor Profile

Medical School Name
WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
5128359080
Graduation Year
1991 (35 years ago)
PAC ID
9739212515
Group Practice PAC ID
3971412677
Professional Enrollment ID
I20171109001867
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

  • McGraw Park Subdivision, Bloomington, McLean County, Illinois, United States

    BLOOMINGTON, IL 617046012

    Phone: (309) 663-2306

    Fax: (309) 662-1213

    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)

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 61704)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYIL11042Removal of skin and tissue first 20 sq cm or less4021
PODIATRYIL11056Removal of 2 to 4 thickened skin growths299103
PODIATRYIL11720Removal of tissue from 1 to 5 finger or toe nails4120

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: 3971412677View full group profile
NameSpecialtyState
P O D I A T R YTX
P O D I A T R YTX
P O D I A T R YIL
P O D I A T R YMA
-IL
-IL
P O D I A T R YNY
P O D I A T R YMO
P O D I A T R YIL
P O D I A T R YMI

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1235240250.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Podiatrist. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Bloomington, Illinois?
For routing, start with Bloomington, Illinois for Unknown Individual, then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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