Unknown Individual – Clinical Psychologist, NPI 1073782132

Unknown Individual is a healthcare provider. based in Joliet, Illinois. specializing in Clinical Psychologist. They hold a License No. 711581 (IL). The NPI Number for Unknown Individual is 1073782132

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1073782132
Phone
(815) 603-2116
Address
815 N LARKIN AVE
Deactivation Date
21 February 2024
Data current as of
20 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

  • 815, Larkin Avenue, Joliet, Will County, Illinois, 60435, United States

    SUITE 204

    JOLIET, IL 604353438

    Phone: (815) 603-2116

    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.

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 60435)

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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 1073782132.
What should I verify if Unknown Individual is listed inactive?
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 Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Joliet, Illinois in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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