Unknown Individual – Clinical Neuropsychologist, NPI 1518033869

Unknown Individual is a healthcare provider. based in Evanston, Illinois. specializing in Clinical Neuropsychologist. They hold a License No. 071002626 (IL). The NPI Number for Unknown Individual is 1518033869

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1518033869
Phone
(847) 425-6407
Address
909 Davis St
Deactivation Date
30 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
9537192539
Group Practice PAC ID
2163334699
Professional Enrollment ID
I20050912000124
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 909 Davis St

    Suite 160

    Evanston, IL 602013645

    Phone: (847) 425-6407

    Fax: (847) 425-6408

    Type: Location

  • 909 DAVIS ST STE 160

    EVANSTON, IL 602013664

    Phone: (847) 425-6400

    Fax: (847) 425-6408

    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.

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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)

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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 60201)

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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: 2163334699View full group profile
NameSpecialtyState
-IL
E N D O C R I N O L O G YIL
N E U R O L O G YIL
Hospitalist, Internal MedicineIL
O P H T H A L M O L O G YIL
-IL
E N D O C R I N O L O G YIL
Cardiovascular Disease (Cardiology), Interventional CardiologyIL
Clinical Social WorkerIL
Certified Nurse Midwife (Cnm)IL

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 1518033869.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Evanston, Illinois?
If you are local to Evanston, 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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