Unknown Individual – Psychiatry Physician, NPI 1265494850

Unknown Individual is a healthcare provider. based in Carbondale, Illinois. specializing in Psychiatry Physician. The NPI Number for Unknown Individual is 1265494850

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265494850
Phone
(618) 549-4688
Address
35 ALBANY RD
Deactivation Date
1 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6183278236
Graduation Year
1971 (55 years ago)
PAC ID
5395831952
Group Practice PAC ID
4880599844
Professional Enrollment ID
I20071012000589
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 35 ALBANY RD

    CARBONDALE, IL 629037605

    Phone: (618) 549-4688

    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)

CMS reports 8 Open Payments records for all available years, with a total value of $334.

Total Amount is formed as General ($334) + Research ($0) + Ownership ($0) = $334.

Last reported payment date: 2024-05-07 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($125).

Total Amount

$334

General + Research + Ownership

Payments

8

Total payment records

General Amount

$334

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-07

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 62903)

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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: 4880599844View full group profile
NameSpecialtyState
Nurse PractitionerIN
R H E U M A T O L O G YIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerMO
-IL
Family Practice, Emergency Medicine, General SurgeryIL
Nurse PractitionerIL
Interventional Cardiology, Peripheral Vascular Disease, Interventional CardiologyTX

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1265494850.
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 does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Carbondale, Illinois?
If you are local to Carbondale, Illinois, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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