Unknown Individual – Optometrist, NPI 1023165412

Unknown Individual is a healthcare provider. based in Tinley park, Illinois. specializing in Optometrist. The NPI Number for Unknown Individual is 1023165412

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023165412
Phone
(708) 532-3450
Address
17112 OAK PARK AVE
Deactivation Date
28 September 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 17112, Oak Park Avenue, Tinley Park, Bremen Township, Cook County, Illinois, 60477, United States

    TINLEY PARK, IL 604773406

    Phone: (708) 532-3450

    Fax: (708) 532-9478

    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 60477)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1023165412 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Tinley Park, Illinois in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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