Unknown Individual – Optometrist, NPI 1861579633

Unknown Individual is a healthcare provider. based in Worth, Illinois. specializing in Optometrist. They hold a License No. 046-008190 (IL). The NPI Number for Unknown Individual is 1861579633

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861579633
Phone
(708) 710-5608
Address
PO BOX 451
Deactivation Date
19 August 2022

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
3870620156
Professional Enrollment ID
I20100419000086
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

  • PO BOX 451

    WORTH, IL 604820451

    Phone: (708) 710-5608

    Type: Mailing

  • 8713, Flint Lane, Park View Estates, Southmoor, Orland Park, Palos Township, Cook County, Illinois, 60462, United States

    ORLAND PARK, IL 604621490

    Phone: (708) 710-5608

    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 60482)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1861579633 in the public NPI dataset.
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 specialty?
The listing groups Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Worth, Illinois may find Unknown Individual in results; validate coverage separately.
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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