Unknown Individual – Pediatrics Physician, NPI 1679567747

Pediatrics Physician

Unknown Individual is a healthcare provider. based in Gurnee, Illinois. specializing in Pediatrics Physician. They hold a License No. 036039791 (IL). The NPI Number for Unknown Individual is 1679567747

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1679567747

Phone

(847) 244-1375

Address

15 TOWER CT

Deactivation Date

4 January 2023

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

15, Tower Court, Gurnee, Lake, Illinois, 60031, United States
SUITE 100
GURNEE, IL 600313336
Phone: (847) 244-1375
Fax: (847) 244-1002
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 60031)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?

The NPI 1679567747 uniquely identifies Unknown Individual in U.S. healthcare data.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Pediatrics Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Gurnee, Illinois in registry-derived data.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.