Unknown Individual – Physician Assistant, NPI 1235253261

Unknown Individual is a healthcare provider. based in Alton, Illinois. specializing in Physician Assistant. They hold a License No. 102402 (MO). The NPI Number for Unknown Individual is 1235253261

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1235253261
Phone
(618) 462-4434
Address
615 ATWOOD ST
Deactivation Date
4 September 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

Provider Addresses for Unknown Individual

  • 615 ATWOOD ST

    ALTON, IL 62002

    Phone: (618) 462-4434

    Type: Mailing

  • 1 BARNES JEWISH HOSPITAL PLZ

    SAINT LOUIS, MO 631101003

    Phone: (314) 454-8134

    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

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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 62002)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1235253261 — the number used across U.S. healthcare to identify this provider.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Alton?
Unknown Individual currently maps to Alton, Illinois in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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