Unknown Individual – Family Medicine Physician, NPI 1396840385

Unknown Individual is a healthcare provider. based in Homewood, Illinois. specializing in Family Medicine Physician. They hold a License No. 036040840 (IL). The NPI Number for Unknown Individual is 1396840385

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1396840385
Phone
Not provided
Address
472 VANDERWALKER LN
Deactivation Date
24 May 2022
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

Provider Addresses for Unknown Individual

  • 472 VANDERWALKER LN

    HOMEWOOD, IL 604304409

    Phone:

    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 60430)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1396840385; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Homewood, Illinois because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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