Unknown Individual – Internal Medicine Physician, NPI 1649279225

Unknown Individual is a healthcare provider. based in Loves park, Illinois. specializing in Internal Medicine Physician. They hold a License No. 36-050049 (IL). The NPI Number for Unknown Individual is 1649279225

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1649279225
Phone
(815) 654-7500
Address
712 WINDSOR RD
Deactivation Date
15 October 2025
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

  • 712, Windsor Road, Loves Park, Machesney Park, Winnebago County, Illinois, 61111, United States

    LOVES PARK, IL 611114153

    Phone: (815) 654-7500

    Fax: (815) 654-7440

    Type: Location

  • 4810, Spring Brook Road, Samuelson Corners, Rockford, Winnebago County, Illinois, 61114, United States

    ROCKFORD, IL 611146358

    Phone: (815) 877-9730

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $50.

Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.

Last reported payment date: 2024-01-12 • Largest payer in this snapshot: Astellas Pharma US Inc ($50).

Total Amount

$50

General + Research + Ownership

Payments

2

Total payment records

General Amount

$50

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-12

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Astellas Pharma US Inc$50
View all Open Payments →|Open Payments Risk Radar →

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 61111)

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Reviews

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

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1649279225.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Loves Park, Illinois in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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Unknown Individual

Internal Medicine Physician
PO BOX 15840
NPI: 1982895157