Unknown Individual – Psychiatry Physician, NPI 1487661930

Unknown Individual is a healthcare provider. based in Danville, Illinois. specializing in Psychiatry Physician. They hold a License No. 036-057064 (IL). The NPI Number for Unknown Individual is 1487661930

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487661930
Phone
(217) 442-3200
Address
210 AVENUE C
Deactivation Date
11 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2174423200
Graduation Year
1968 (58 years ago)
PAC ID
7719172741
Group Practice PAC ID
0547212250
Professional Enrollment ID
I20101116000363
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

  • 210, Avenue C, Vermilion Heights, Danville, Vermilion County, Illinois, 61832, United States

    DANVILLE, IL 618325410

    Phone: (217) 442-3200

    Fax: (217) 442-7460

    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 24 Open Payments records for all available years, with a total value of $426.

Total Amount is formed as General ($426) + Research ($0) + Ownership ($0) = $426.

Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($149).

Total Amount

$426

General + Research + Ownership

Payments

24

Total payment records

General Amount

$426

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-15

Latest reported date

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes15462$0
99213Established patient office or other outpatient visit, 20-29 minutes4426$0
View full utilization report →

Insurance plans in this area (ZIP 61832)

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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: 0547212250View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerOH
Nurse PractitionerAZ
Clinical Social WorkerIL
Nurse PractitionerIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1487661930 — is the standard way to identify this listing.
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's primary classification?
Psychiatry Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Danville, Illinois in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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CROSSPOINT HUMAN SERVICES

Mental Health Clinic/Center (Including Community Mental Health Center)
210, Avenue C, Vermilion Heights, Danville, Vermilion County, Illinois, 61832, United States
NPI: 1538254214