Unknown Individual – Clinical Social Worker, NPI 1730288234

Unknown Individual is a healthcare provider. based in Portage, Indiana. specializing in Clinical Social Worker. They hold a License No. 34001836A (IN). The NPI Number for Unknown Individual is 1730288234

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1730288234
Phone
(219) 762-9995
Address
5877 CENTRAL AVE
Deactivation Date
25 December 2025

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
2198794621
Graduation Year
1987 (39 years ago)
PAC ID
3870555881
Group Practice PAC ID
3274703046
Professional Enrollment ID
I20041102000433
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

  • Central Avenue, Portage, Porter County, Indiana, 46368, United States

    SUITE A

    PORTAGE, IN 463682920

    Phone: (219) 762-9995

    Fax: (219) 762-9995

    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 46368)

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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: 3274703046View full group profile
NameSpecialtyState
Clinical Social WorkerIN
-IN
Nurse PractitionerIN
Clinical Social WorkerIN
Clinical Social WorkerIN
Clinical Social WorkerIN
Nurse PractitionerIN
Clinical Social WorkerIN
Marriage And Family TherapistIN
-IN

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1730288234 uniquely identifies Unknown Individual in U.S. healthcare data.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Portage, Indiana in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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