Unknown Individual – Family Medicine Physician, NPI 1477780625

Unknown Individual is a healthcare provider. based in Evanston, Illinois. specializing in Family Medicine Physician. They hold a License No. 036-128931 (IL). The NPI Number for Unknown Individual is 1477780625

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1477780625
Phone
(419) 346-6450
Address
633 EMERSON ST
Deactivation Date
13 March 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

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Provider Addresses for Unknown Individual

  • Searle Hall, 633, Emerson Street, Downtown, Evanston, Evanston Township, Cook County, Illinois, 60208, United States

    EVANSTON, IL 602080844

    Phone: (419) 346-6450

    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 60208)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1477780625 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Evanston, Illinois may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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