Unknown Individual – Optometrist, NPI 1972501278

Unknown Individual is a healthcare provider. based in Downers grove, Illinois. specializing in Optometrist. They hold a License No. 466855 (IL). The NPI Number for Unknown Individual is 1972501278

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972501278
Phone
(630) 960-0456
Address
3800 HIGHLAND AVE
Deactivation Date
28 January 2022

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
8157581039
Graduation Year
1976 (50 years ago)
PAC ID
7416017942
Group Practice PAC ID
8224019450
Professional Enrollment ID
I20110222000038
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

  • Peggy A Supple, M.D., 3800, Highland Avenue, Downers Grove, DuPage County, Illinois, 60515, United States

    STE. 100

    DOWNERS GROVE, IL 605151557

    Phone: (630) 960-0456

    Fax: (630) 960-9521

    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 60515)

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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: 8224019450View full group profile
NameSpecialtyState
O P T O M E T R YIL
-IL
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1972501278 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Downers Grove, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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