Unknown Individual – Clinical Social Worker, NPI 1619301058

Unknown Individual is a healthcare provider. based in Eureka, Illinois. specializing in Clinical Social Worker. They hold a License No. 149015895 (IL). The NPI Number for Unknown Individual is 1619301058

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1619301058
Phone
(907) 467-2579
Address
609 W MAPLE DR
Deactivation Date
17 April 2025
Data current as of
20 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

  • 609 W MAPLE DR

    EUREKA, IL 615301340

    Phone: (907) 467-2579

    Type: Mailing

  • 108 W MARKET ST

    BLOOMINGTON, IL 617013918

    Phone: (309) 827-5351

    Fax: (309) 829-6808

    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.

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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 61530)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1619301058.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Eureka?
Public fields place Unknown Individual around Eureka, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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