Unknown Individual – Physical Therapist, NPI 1588712756

Unknown Individual is a healthcare provider. based in Belleville, Illinois. specializing in Physical Therapist. The NPI Number for Unknown Individual is 1588712756

Main info

Organization
Inactive
40 Years Of Experience
Name
Unknown Individual
NPI
1588712756
Phone
(618) 236-7588
Address
106 LINCOLN PLACE CT
Deactivation Date
21 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6182367588
Graduation Year
1986 (40 years ago)
PAC ID
8729020193
Group Practice PAC ID
8628010089
Professional Enrollment ID
I20101129000731
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 106 LINCOLN PLACE CT

    BELLEVILLE, IL 622215884

    Phone: (618) 236-7588

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes11512$0
View full utilization report →

Insurance plans in this area (ZIP 62221)

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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: 8628010089View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1588712756 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
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?
Physical Therapist 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 Belleville, Illinois in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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