Unknown Individual – Pediatrics Physician, NPI 1164441879

Unknown Individual is a healthcare provider. based in Normal, Illinois. specializing in Pediatrics Physician. The NPI Number for Unknown Individual is 1164441879

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164441879
Phone
(309) 268-2727
Address
1302 FRANKLIN AVE STE 1100
Deactivation Date
1 February 2023
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

Provider Addresses for Unknown Individual

  • 1302 FRANKLIN AVE STE 1100

    NORMAL, IL 617610016

    Phone: (309) 268-2727

    Fax: (309) 268-6513

    Type: Location

  • Bloomington Post Office, South Walnut Street, Bloomington, Monroe County, Indiana, 47401, United States

    BLOOMINGTON, IL 617022451

    Phone: (309) 268-2172

    Fax: (309) 268-3649

    Type: Mailing

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 61761)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1164441879.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Pediatrics Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Normal, Illinois may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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