Unknown Individual – Pediatric Endocrinology Physician, NPI 1336114636

Unknown Individual is a healthcare provider. based in Peoria, Illinois. specializing in Pediatric Endocrinology Physician. The NPI Number for Unknown Individual is 1336114636

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1336114636
Phone
(309) 671-8503
Address
1 ILLINI DR
Deactivation Date
30 August 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

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Provider Addresses for Unknown Individual

  • Univerity of Illinois College of Medicine at Peoria, 1, Illini Drive, Peoria, Peoria County, Illinois, 61605, United States

    PEORIA, IL 616052576

    Phone: (309) 671-8503

    Type: Mailing

  • 507, East Armstrong Avenue, Peoria, Peoria County, Illinois, 61603, United States

    REGIONAL DEVELOPMENT CENTER

    PEORIA, IL 616033201

    Phone: (309) 681-6960

    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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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 61605)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1336114636 for Unknown Individual, then check state licensing separately.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Pediatric Endocrinology Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Peoria, Illinois; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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