Unknown Individual – Otolaryngology Physician, NPI 1063442457

Unknown Individual is a healthcare provider. based in Bloomington, Illinois. specializing in Otolaryngology Physician. They hold a License No. 036090897 (IL). The NPI Number for Unknown Individual is 1063442457

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063442457
Phone
(309) 662-9001
Address
3801 GENERAL ELECTRIC RD STE 4
Deactivation Date
1 November 2022
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

  • General Electric Road, Bloomington, McLean County, Illinois, 61767, United States

    BLOOMINGTON, IL 617044193

    Phone: (309) 662-9001

    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.

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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 61704)

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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 1063442457; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Illinois?
You will see Bloomington, Illinois on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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