Unknown Individual – Clinical Psychologist, NPI 1366648149

Unknown Individual is a healthcare provider. based in Dekalb, Illinois. specializing in Clinical Psychologist. The NPI Number for Unknown Individual is 1366648149

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366648149
Phone
(815) 761-2686
Address
400 E HILLCREST DR
Deactivation Date
5 February 2026
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

  • 400, East Hillcrest Drive, DeKalb, DeKalb County, Illinois, 60115, United States

    SUITE 100A

    DEKALB, IL 601152480

    Phone: (815) 761-2686

    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.

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 60115)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1366648149.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Dekalb, Illinois. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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