Unknown Individual – Clinical Psychologist, NPI 1053411710

Unknown Individual is a healthcare provider. based in Cary, Illinois. specializing in Clinical Psychologist. The NPI Number for Unknown Individual is 1053411710

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053411710
Phone
(847) 702-2532
Address
57 S PRAIRIE ST
Deactivation Date
12 April 2023
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

  • 57, South Prairie Street, Cary, McHenry County, Illinois, 60013, United States

    CARY, IL 600132614

    Phone: (847) 702-2532

    Fax: (847) 991-8699

    Type: Mailing

  • 271, Country Commons Road, Cary, McHenry County, Illinois, 60013, United States

    SUITE H

    TROUT VALLEY, IL 600132543

    Phone: (847) 702-2532

    Fax: (847) 991-8699

    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 60013)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1053411710; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Cary, Illinois because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1053411710. Always confirm identity and privileges with the practice and licensing boards.

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