Unknown Individual – Physical Therapist, NPI 1508917543

Unknown Individual is a healthcare provider. based in Mount vernon, Illinois. specializing in Physical Therapist. The NPI Number for Unknown Individual is 1508917543

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1508917543
Phone
(618) 244-7200
Address
3307 BROADWAY ST
Deactivation Date
11 October 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 3307, Broadway Street, Mount Vernon, Jefferson County, Illinois, 62864, United States

    SUITE 140

    MOUNT VERNON, IL 628642347

    Phone: (618) 244-7200

    Type: Location

  • 2665 SNEED RD

    CARBONDALE, IL 629020443

    Phone: (618) 964-1647

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 62864)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1508917543 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Mount Vernon, Illinois for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1508917543. Always confirm identity and privileges with the practice and licensing boards.

Similar Providers

Crossroads Community Hospital, 8, Doctors Park Road, Mount Vernon, Jefferson County, Illinois, 62864, United States
NPI: 1043296023

MS. TRACY HAMON (P.T.)

Physical Therapist
1639, West Willow Brook Drive, Nashville, Washington County, Illinois, 62263, United States
NPI: 1750358578

MRS. JILL BURNETT LISK (PT)

Physical Therapist
18377 E ACORN RD
NPI: 1982662920

JASON PAUL WHITE (P.T.)

Physical Therapist
19863 E FAIRFIELD RD
NPI: 1942250287
Orthopaedic Center of Southern Illinois, 4121, Veterans Memorial Drive, Mount Vernon, Jefferson County, Illinois, 62864, United States
NPI: 1730131152
Orthopaedic Center of Southern Illinois, 4121, Veterans Memorial Drive, Mount Vernon, Jefferson County, Illinois, 62864, United States
NPI: 1821041658
Orthopaedic Center of Southern Illinois, 4121, Veterans Memorial Drive, Mount Vernon, Jefferson County, Illinois, 62864, United States
NPI: 1124071915

SYNERGY THERAPEUTIC GROUP

Physical Therapist
412 S 34TH ST STE 201
NPI: 1659393411

JAMES M MULVANEY

Physical Therapist
4227, Lincolnshire Drive, Mount Vernon, Jefferson County, Illinois, 62864, United States
NPI: 1053423020