Unknown Individual – Family Nurse Practitioner, NPI 1124094545

Unknown Individual is a healthcare provider. based in Freeport, Illinois. specializing in Family Nurse Practitioner. They hold a License No. 041259043 (IL). The NPI Number for Unknown Individual is 1124094545

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124094545
Phone
(815) 599-7958
Address
421 W EXCHANGE ST
Deactivation Date
8 November 2024
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

  • West Exchange Street, Freeport, Stephenson County, Illinois, 61032, United States

    PO BOX 268

    FREEPORT, IL 610324030

    Phone: (815) 599-7958

    Type: Mailing

  • 725, North Pearl Street, Stockton, Jo Daviess County, Illinois, 61085, United States

    STOCKTON, IL 610859267

    Phone: (815) 947-3211

    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 61032)

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Provider's Procedures

Unknown Individual performs procedures in Family Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERIL85610Blood test, clotting time7915
NURSE PRACTITIONERIL90670Pneumococcal vaccine for injection into muscle1818

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1124094545.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Freeport, Illinois; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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