Unknown Individual – Obstetrics & Gynecology Physician, NPI 1679688196

Unknown Individual is a healthcare provider. based in Urbana, Illinois. specializing in Obstetrics & Gynecology Physician. They hold a License No. 036067122 (IL). The NPI Number for Unknown Individual is 1679688196

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679688196
Phone
(217) 383-6792
Address
611 W PARK ST
Deactivation Date
1 June 2024
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

  • Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States

    BWPC

    URBANA, IL 618012529

    Phone: (217) 383-6792

    Type: Mailing

  • Hurst Drive, Mattoon, Coles County, Illinois, United States

    MATTOON, IL 619389200

    Phone: (217) 258-5900

    Fax: (217) 258-5904

    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.

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.

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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 61801)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1679688196.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Obstetrics & Gynecology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Urbana, Illinois; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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