Unknown Individual – Family Nurse Practitioner, NPI 1558348326

Unknown Individual is a healthcare provider. based in Bloomington, Illinois. specializing in Family Nurse Practitioner. They hold a License No. 209002086 (IL). The NPI Number for Unknown Individual is 1558348326

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1558348326
Phone
(309) 663-8311
Address
1401 EASTLAND DR
Deactivation Date
17 March 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

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Provider Addresses for Unknown Individual

  • 1401, Eastland Drive, Bloomington, McLean County, Illinois, 61701, United States

    BLOOMINGTON, IL 617013514

    Phone: (309) 663-8311

    Fax: (309) 663-1810

    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 61701)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1558348326 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Bloomington?
Public fields place Unknown Individual around Bloomington, Illinois. Always confirm the exact site before visiting.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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