Unknown Individual – Obstetrics & Gynecology Physician, NPI 1255350039

Unknown Individual is a healthcare provider. based in Urbana, Illinois. specializing in Obstetrics & Gynecology Physician. The NPI Number for Unknown Individual is 1255350039

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1255350039
Phone
(217) 383-3311
Address
602 W UNIVERSITY AVE
Deactivation Date
14 June 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

  • 602, West University Avenue, Downtown Urbana, Urbana, Champaign County, Illinois, 61801, United States

    URBANA, IL 618012530

    Phone: (217) 383-3311

    Type: Mailing

  • Carle Champaign on Kirby, 1813, West Kirby Avenue, Champaign, Champaign County, Illinois, 61821, United States

    CHAMPAIGN, IL 618215410

    Phone: (217) 326-1220

    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 61801)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1255350039 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Urbana, Illinois for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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