Unknown Individual – Psychiatry Physician, NPI 1376535427

Unknown Individual is a healthcare provider. based in Edwardsville, Illinois. specializing in Psychiatry Physician. They hold a License No. 107855 (MO). The NPI Number for Unknown Individual is 1376535427

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1376535427
Phone
(618) 692-9640
Address
PO BOX 790
Deactivation Date
10 April 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 790

    EDWARDSVILLE, IL 620250790

    Phone: (618) 692-9640

    Fax: (618) 692-9643

    Type: Mailing

  • 103A SOUTH POINTE DRIVE

    EDWARDSVILLE, IL 620253780

    Phone: (618) 656-2000

    Fax: (618) 656-1169

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $171.

Total Amount is formed as General ($171) + Research ($0) + Ownership ($0) = $171.

Last reported payment date: 2023-12-19 • Largest payer in this snapshot: ABBVIE INC. ($171).

Total Amount

$171

General + Research + Ownership

Payments

12

Total payment records

General Amount

$171

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$171
View all Open Payments →|Open Payments Risk Radar →

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 62025)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYIL90833Psychotherapy, 30 minutes with patient and/or family member306100
PSYCHIATRYIL90836Psychotherapy, 45 minutes with patient and/or family member3433

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1376535427 — the number used across U.S. healthcare to identify this provider.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Edwardsville, Illinois.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.