Unknown Individual – Chiropractor, NPI 1083623615

Unknown Individual is a healthcare provider. based in Glen carbon, Illinois. specializing in Chiropractor. The NPI Number for Unknown Individual is 1083623615

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083623615
Phone
(618) 692-9763
Address
38 COBBLESTONE LN
Deactivation Date
25 August 2021
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

  • 38, Cobblestone Lane, Glen Carbon, Madison County, Illinois, 62034, United States

    GLEN CARBON, IL 620341496

    Phone: (618) 692-9763

    Fax: (618) 692-9772

    Type: Mailing

  • 340, South Fillmore Street, Edwardsville, Madison County, Illinois, 62025, United States

    EDWARDSVILLE, IL 620252115

    Phone: (618) 692-9763

    Fax: (618) 692-9772

    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 62034)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1083623615 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Chiropractor. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Illinois?
You will see Glen Carbon, Illinois on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1083623615. Always confirm identity and privileges with the practice and licensing boards.

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