Unknown Individual – Internal Medicine Physician, NPI 1477529675

Unknown Individual is a healthcare provider. based in Freeport, Illinois. specializing in Internal Medicine Physician. They hold a License No. 036074925 (IL). The NPI Number for Unknown Individual is 1477529675

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1477529675
Phone
(815) 599-7950
Address
421 W EXCHANGE ST
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
8155996000
Graduation Year
1985 (41 years ago)
PAC ID
4587711395
Group Practice PAC ID
9234041682
Professional Enrollment ID
I20100206000125
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

  • West Exchange Street, Freeport, Stephenson County, Illinois, 61032, United States

    PO BOX 268

    FREEPORT, IL 610324030

    Phone: (815) 599-7950

    Type: Mailing

  • Fairway Drive, Freeport, Stephenson County, Illinois, 61032, United States

    FREEPORT, IL 610326600

    Phone: (815) 599-7790

    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 61032)

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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: 9234041682View full group profile
NameSpecialtyState
PRASAD K. KILARU (MD)
Interventional CardiologyIL
ROBERT GELLER (MD)
Infectious Disease, Internal MedicineIL
SHOKRY TAWFIK (MD)
Family PracticeIL
TRACY L DYSARD (NP)
-DE
APRIL MOORE (MD)
Family PracticeIL
MS. LEE SESSLAR (MD)
O B S T E T R I C S/ G Y N E C O L O G YIL
DR. RENU DOSI (M.D.)
-IL
MICHAEL J MCFADDEN
Family PracticeIL
DR. KEVIN D DRAXINGER (M.D.)
Orthopedic SurgeryIL
TERRY L MILLER (MD)
Family PracticeIL

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 1477529675.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Freeport, Illinois in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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