Unknown Individual – Optometrist, NPI 1477540318

Unknown Individual is a healthcare provider. based in Bloomington, Illinois. specializing in Optometrist. They hold a License No. 046006095 (IL). The NPI Number for Unknown Individual is 1477540318

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1477540318
Phone
(309) 829-5311
Address
1008 N MAIN ST
Deactivation Date
30 October 2024
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

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Provider Addresses for Unknown Individual

  • 1008, North Main Street, Cultural District, Bloomington, McLean County, Illinois, 61701, United States

    BLOOMINGTON, IL 617011784

    Phone: (309) 829-5311

    Fax: (309) 827-8027

    Type: Mailing

  • 2475, North Monroe Street, Decatur, Macon County, Illinois, 62526, United States

    DECATUR, IL 625263941

    Phone: (217) 875-5900

    Fax: (217) 875-5600

    Type: Location

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 61701)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1477540318.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Optometrist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Bloomington, Illinois as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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