Unknown Individual – Family Nurse Practitioner, NPI 1356625727

Unknown Individual is a healthcare provider. based in Flossmoor, Illinois. specializing in Family Nurse Practitioner. They hold a License No. 209.009110 (IL). The NPI Number for Unknown Individual is 1356625727

Main info

Organization
Inactive
15 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356625727
Phone
(708) 798-7998
Address
3220 195TH ST
Deactivation Date
8 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732571110
Graduation Year
2011 (15 years ago)
PAC ID
8820264286
Group Practice PAC ID
5991600405
Professional Enrollment ID
I20120105000947
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 3220 195TH ST

    FLOSSMOOR, IL 604221700

    Phone: (708) 798-7998

    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 60422)

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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: 5991600405View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology), Internal MedicineIL
Diagnostic Radiology, Interventional RadiologyIL
Radiation Oncology, Diagnostic RadiologyIL
Hematology/Oncology, Internal MedicineIL
Endocrinology, Internal MedicineIL
Internal MedicineIL
Internal Medicine, Sleep MedicineIL
-IL
P A T H O L O G YIL
General Surgery, Colorectal Surgery (Proctology)IL

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1356625727 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Flossmoor, Illinois in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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