Unknown Individual – Obstetrics & Gynecology Physician, NPI 1609840750

Unknown Individual is a healthcare provider. based in Morris, Illinois. specializing in Obstetrics & Gynecology Physician. They hold a License No. 36068364 (IL). The NPI Number for Unknown Individual is 1609840750

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609840750
Phone
(815) 941-0441
Address
237 W WAVERLY ST
Deactivation Date
28 July 2022

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
8159410441
Graduation Year
1981 (45 years ago)
PAC ID
1759319254
Group Practice PAC ID
1850372459
Professional Enrollment ID
I20050727000068
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

  • 237, West Waverly Street, Morris, Grundy County, Illinois, 60450, United States

    MORRIS, IL 604501334

    Phone: (815) 941-0441

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60450)

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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: 1850372459View full group profile
NameSpecialtyState
Family PracticeIL
Nurse PractitionerIL
Nurse PractitionerIL
Internal Medicine, Pediatric MedicineIL
-IL
Nurse PractitionerIL
Orthopedic SurgeryNY
Nurse PractitionerIL
Family PracticeIL
Allergy/Immunology, Internal MedicineIL

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1609840750 — is the standard way to identify this listing.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Obstetrics & Gynecology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Morris, Illinois; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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