Unknown Individual – Internal Medicine Physician, NPI 1881769735

Unknown Individual is a healthcare provider. based in Riverside, Illinois. specializing in Internal Medicine Physician. They hold a License No. 036054285 (IL). The NPI Number for Unknown Individual is 1881769735

Main info

Organization
Inactive
52 Years Of Experience
Name
Unknown Individual
NPI
1881769735
Phone
(708) 442-6006
Address
353 E BURLINGTON
Deactivation Date
16 November 2022

Doctor Profile

Medical School Name
CHICAGO COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
6800935230
Professional Enrollment ID
I20091125000057
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

  • Riverside Township, Burlington County, New Jersey, 08075, United States

    SUITE 202

    RIVERSIDE, IL 60546

    Phone: (708) 442-6006

    Fax: (708) 442-6829

    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 60546)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1881769735 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Riverside, 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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