Unknown Individual – Psychiatry Physician, NPI 1376551630

Unknown Individual is a healthcare provider. based in Highland park, Illinois. specializing in Psychiatry Physician. The NPI Number for Unknown Individual is 1376551630

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1376551630
Phone
(847) 433-8884
Address
450 CENTRAL AVE
Deactivation Date
6 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience10
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 450, Central Avenue, Downtown Highland Park, Highland Park, Lake County, Illinois, 60035, United States

    SUITE 211

    HIGHLAND PARK, IL 600352684

    Phone: (847) 433-8884

    Fax: (847) 433-5345

    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 60035)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1376551630.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Highland Park, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.