Unknown Individual – Family Medicine Physician, NPI 1366581175

Family Medicine Physician

Unknown Individual is a healthcare provider. based in River forest, Illinois. specializing in Family Medicine Physician. The NPI Number for Unknown Individual is 1366581175

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1366581175

Phone

(708) 771-4588

Address

902 MONROE AVE

Deactivation Date

11 December 2025

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

902 MONROE AVE
RIVER FOREST, IL 603051424
Phone: (708) 771-4588
Mailing address matches the actual address.

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.

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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 60305)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?

Unknown Individual — NPI 1366581175 — is the standard way to identify this listing.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

What address line appears for Unknown Individual?

Unknown Individual's geographic hint is River Forest, Illinois in our summary view.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.