Unknown Individual – Physical Therapist, NPI 1962956235

Unknown Individual is a healthcare provider. based in Oak brook, Illinois. specializing in Physical Therapist. They hold a License No. 5501017802 (MI). The NPI Number for Unknown Individual is 1962956235

Main info

Organization
Inactive
10 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962956235
Phone
(630) 575-1932
Address
625 ENTERPRISE DR
Deactivation Date
26 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5174392376
Graduation Year
2016 (10 years ago)
PAC ID
2860788874
Group Practice PAC ID
4789602681
Professional Enrollment ID
I20160830003205
Data current as of
20 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

  • 625, Enterprise Drive, Oak Brook, DuPage County, Illinois, 60523, United States

    OAK BROOK, IL 605238813

    Phone: (630) 575-1932

    Fax: (630) 928-5032

    Type: Mailing

  • 16, West Carleton Road, Hillsdale, Fayette Township, Hillsdale County, Michigan, 49242, United States

    STE 1

    HILLSDALE, MI 492421226

    Phone: (517) 439-2376

    Fax: (517) 439-2379

    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 60523)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMI97001Physical therapy evaluation1919

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: 4789602681View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
-IL
-IL
Physical Therapist In Private PracticeVA
-MI
-IL
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-MI

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1962956235 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Oak Brook, Illinois in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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