Unknown Individual – Clinical Child & Adolescent Psychologist, NPI 1649252495

Unknown Individual is a healthcare provider. based in Springfield, Illinois. specializing in Clinical Child & Adolescent Psychologist. They hold a License No. 071-002533 (IL). The NPI Number for Unknown Individual is 1649252495

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1649252495
Phone
(217) 545-2618
Address
PO BOX 19658
Deactivation Date
18 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 19658

    SPRINGFIELD, IL 627949658

    Phone: (217) 545-2618

    Fax: (217) 545-5834

    Type: Mailing

  • North 8th Street, Springfield, Sangamon County, Illinois, 62707, United States

    SPRINGFIELD, IL 627011041

    Phone: (217) 545-2618

    Fax: (217) 545-5834

    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 62794)

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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 1649252495.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Clinical Child & Adolescent Psychologist. Clinical services aligned with this taxonomy classification.
Where in Illinois is Unknown Individual registered?
Use Springfield, Illinois as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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