Unknown Individual – Pediatrics Physician, NPI 1063483683

Unknown Individual is a healthcare provider. based in St charles, Illinois. specializing in Pediatrics Physician. They hold a License No. 36-64686 (IL). The NPI Number for Unknown Individual is 1063483683

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063483683
Phone
(630) 584-4860
Address
5N380 RONSU LN
Deactivation Date
15 May 2025
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

  • 5N380 RONSU LN

    ST CHARLES, IL 601756216

    Phone: (630) 584-4860

    Type: Mailing

  • 970, North 5th Avenue, St. Charles, St. Charles Township, Kane County, Illinois, 60174, United States

    ST CHARLES, IL 601741227

    Phone: (630) 584-1950

    Fax: (630) 584-8994

    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.

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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 60175)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1063483683 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes St Charles, Illinois for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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