Unknown Individual – Psychologist, NPI 1427083567

Unknown Individual is a healthcare provider. based in Urbana, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. 071006738 (IL). The NPI Number for Unknown Individual is 1427083567

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1427083567
Phone
(217) 383-3431
Address
602 W. UNIVERSITY AVENUE
Deactivation Date
9 April 2026

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8887122753
Graduation Year
1991 (35 years ago)
PAC ID
2264499938
Group Practice PAC ID
3577515774
Professional Enrollment ID
I20041214000713
Address ID
IL618012501UR611XXSTXX400
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

1,600 CLINICAL PSYCHOLOGIST in IL

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Provider Addresses for Unknown Individual

  • 602, West University Avenue, Downtown Urbana, Urbana, Champaign County, Illinois, 61801, United States

    PSYCHIATRY/PSYCHOLOGY

    URBANA, IL 61801

    Phone: (217) 383-3431

    Type: Location

  • ESBU Bernardo Domínguez, Paseo, Vedado – Malecón, Plaza de la Revolución, Havana, 33100, Cuba

    URBANA, IL 618036002

    Phone: (217) 326-8300

    Type: Mailing

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 61801)

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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: 3577515774View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YIL
Nurse PractitionerIL
Clinical PsychologistIL
-FL
Nurse PractitionerIL
Gastroenterology, Internal MedicineWI
P O D I A T R YIL
Hospitalist, Family PracticeTX
Diagnostic RadiologyNY
-IL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1427083567?
NPI 1427083567 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Urbana, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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