Unknown Individual – Clinical Social Worker, NPI 1881931442

Unknown Individual is a healthcare provider. based in Bolingbrook, Illinois. specializing in Clinical Social Worker. They hold a License No. 150.01352 (IL). The NPI Number for Unknown Individual is 1881931442

Main info

Organization
Inactive
15 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1881931442
Phone
(331) 318-8181
Address
440 BOUGHTON AVE STE 104
Deactivation Date
21 June 2021

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
6309201795
Graduation Year
2011 (15 years ago)
PAC ID
1759603988
Group Practice PAC ID
2163619099
Professional Enrollment ID
I20141125001285
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

Provider Addresses for Unknown Individual

  • 440 BOUGHTON AVE STE 104

    BOLINGBROOK, IL 604401234

    Phone: (331) 318-8181

    Type: Mailing

  • 440 W BOUGHTON RD

    STE 104

    BOLINGBROOK, IL 604401892

    Phone: (331) 318-8181

    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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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: 2163619099View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Clinical Social WorkerIL
Clinical Social WorkerIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
P S Y C H I A T R YIL
-IL
P S Y C H I A T R YIL
P S Y C H I A T R YIL
P S Y C H I A T R YIL

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1881931442 for Unknown Individual, then check state licensing separately.
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 taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Bolingbrook, Illinois; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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