Unknown Individual – Obstetrics & Gynecology Physician, NPI 1790707743

Unknown Individual is a healthcare provider. based in Downers grove, Illinois. specializing in Obstetrics & Gynecology Physician. They hold a License No. 036089891 (IL). The NPI Number for Unknown Individual is 1790707743

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790707743
Phone
(630) 810-9568
Address
4333 MAIN ST
Deactivation Date
14 December 2022

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1991 (35 years ago)
PAC ID
8022032556
Professional Enrollment ID
I20060123000869
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4333, Main Street, Downers Grove, DuPage County, Illinois, 60515, United States

    DOWNERS GROVE, IL 605152869

    Phone: (630) 810-9568

    Fax: (630) 810-1027

    Type: Location

  • 17th Place, Highland Hills, Lombard, DuPage County, Illinois, 60148, United States

    LOMBARD, IL 601484926

    Phone: (630) 629-9663

    Fax: (877) 719-0716

    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.

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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 60515)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1790707743.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Downers Grove?
Public fields place Unknown Individual around Downers Grove, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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