Unknown Individual – Optometrist, NPI 1053328401

Unknown Individual is a healthcare provider. based in Henderson, Illinois. specializing in Optometrist. The NPI Number for Unknown Individual is 1053328401

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053328401
Phone
(309) 344-3210
Address
PO BOX 204
Deactivation Date
1 January 2026
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

  • PO BOX 204

    HENDERSON, IL 614390204

    Phone: (309) 344-3210

    Type: Mailing

  • Walmart Supercenter, 3320, Veterans Drive, Pekin, Tazewell County, Illinois, 61554, United States

    PEKIN, IL 615549317

    Phone: (309) 353-4220

    Fax: (309) 353-4222

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $355.

Total Amount is formed as General ($355) + Research ($0) + Ownership ($0) = $355.

Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($224).

Total Amount

$355

General + Research + Ownership

Payments

4

Total payment records

General Amount

$355

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 61439)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1053328401.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Henderson, Illinois in registry-derived data.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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