Unknown Individual – Clinical Psychologist, NPI 1063512036

Unknown Individual is a healthcare provider. based in Highland park, Illinois. specializing in Clinical Psychologist. They hold a License No. 071-004554 (IL). The NPI Number for Unknown Individual is 1063512036

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063512036
Phone
(847) 780-4900
Address
660 LASALLE PLACE
Deactivation Date
30 April 2026
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

Provider Addresses for Unknown Individual

  • 660 LASALLE PLACE

    SUITE 1A

    HIGHLAND PARK, IL 60035

    Phone: (847) 780-4900

    Fax: (847) 945-0853

    Type: Location

  • Country Court, Deerfield, Lake County, Illinois, 60015, United States

    DEERFIELD, IL 600154721

    Phone: (800) 508-2200

    Fax: (847) 945-0853

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60035)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1063512036.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Highland Park, Illinois. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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