Unknown Individual – Internal Medicine Physician, NPI 1114901675

Unknown Individual is a healthcare provider. based in Lake villa, Illinois. specializing in Internal Medicine Physician. They hold a License No. 036056585 (IL). The NPI Number for Unknown Individual is 1114901675

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114901675
Phone
(847) 356-3471
Address
411 CLARIDGE CT
Deactivation Date
6 February 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

  • 411, Claridge Court, Lake Villa, Lake County, Illinois, 60046, United States

    LAKE VILLA, IL 600465076

    Phone: (847) 356-3471

    Type: Mailing

  • 6th Street, Great Lakes, North Chicago, Lake County, Illinois, 60088, United States

    NAVAL HOSPITAL GREAT LAKES

    GREAT LAKES, IL 600885230

    Phone: (847) 688-4560

    Fax: (847) 688-2678

    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 60046)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1114901675 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Lake Villa?
Unknown Individual currently maps to Lake Villa, Illinois in this extract.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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