Unknown Individual – Clinical Psychologist, NPI 1336199108

Unknown Individual is a healthcare provider. based in Berwyn, Illinois. specializing in Clinical Psychologist. They hold a License No. 071-002365 (IL). The NPI Number for Unknown Individual is 1336199108

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1336199108
Phone
(708) 749-0540
Address
3303S GROVE AVE
Deactivation Date
23 October 2025
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

  • 3303S GROVE AVE

    BERWYN, IL 604023422

    Phone: (708) 749-0540

    Fax: (708) 749-0187

    Type: Mailing

  • 3265, West Armitage Avenue, Chicago, Jefferson Township, Cook County, Illinois, 60647, United States

    CHICAGO, IL 606473759

    Phone: (773) 862-4675

    Fax: (773) 862-4685

    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

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 60402)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1336199108.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Berwyn, Illinois in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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