Unknown Individual – Dermatology Physician, NPI 1679550735

Unknown Individual is a healthcare provider. based in Maywood, Illinois. specializing in Dermatology Physician. They hold a License No. 36102114 (IL). The NPI Number for Unknown Individual is 1679550735

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679550735
Phone
(708) 216-9000
Address
2160 S 1ST AVE
Deactivation Date
19 March 2026
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

  • South 1st Avenue, Maywood, Proviso Township, Cook County, Illinois, 60141, United States

    LOYOLA UNIVERSITY MEDICAL CENTER 101-1740

    MAYWOOD, IL 601533328

    Phone: (708) 216-9000

    Fax: (708) 216-9033

    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 60153)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1679550735 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Illinois?
You will see Maywood, Illinois on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1679550735. Always confirm identity and privileges with the practice and licensing boards.

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