Unknown Individual – Ophthalmology Physician, NPI 1891710257

Unknown Individual is a healthcare provider. based in Aurora, Illinois. specializing in Ophthalmology Physician. They hold a License No. 036-104707 (IL). The NPI Number for Unknown Individual is 1891710257

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891710257
Phone
(630) 859-6800
Address
2357 SEQUOIA DR
Deactivation Date
17 October 2021

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6305857100
Graduation Year
1992 (34 years ago)
PAC ID
8426045022
Group Practice PAC ID
0547172629
Professional Enrollment ID
I20040427000481
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

  • 2357, Sequoia Drive, Aurora, Kane County, Illinois, 60506, United States

    AURORA, IL 605066222

    Phone: (630) 859-6800

    Type: Mailing

  • Advocate Medical Group Outpatient Center, 1221, North Highland Avenue, Aurora, Kane County, Illinois, 60506, United States

    AURORA, IL 605061404

    Phone: (630) 859-8700

    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.

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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 60506)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYIL92012Eye and medical examination for diagnosis and treatment, established patient1515

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: 0547172629View full group profile

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1891710257 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is Unknown Individual registered?
Use Aurora, Illinois as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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