Unknown Individual – Optometrist, NPI 1841370061

Unknown Individual is a healthcare provider. based in Bolingbrook, Illinois. specializing in Optometrist. The NPI Number for Unknown Individual is 1841370061

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1841370061
Phone
(630) 759-1330
Address
105 CONCORD LANE
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
6309689440
Graduation Year
1978 (48 years ago)
PAC ID
1658366794
Group Practice PAC ID
5395730535
Professional Enrollment ID
I20040417000375
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

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Provider Addresses for Unknown Individual

  • 105, Concord Lane, Winston Trails, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 60440

    Phone: (630) 759-1330

    Fax: (630) 968-0180

    Type: Mailing

  • Walgreens, 7516, South Cass Avenue, Darien, DuPage County, Illinois, 60561, United States

    BROOKHAVEN PLAZA

    DARIEN, IL 605614496

    Phone: (630) 968-9440

    Fax: (630) 968-0180

    Type: Location

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 60440)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1841370061 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Bolingbrook, Illinois.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.