Unknown Individual – Endodontics, NPI 1700158227

Unknown Individual is a healthcare provider. based in Peoria, Illinois. specializing in Endodontics. They hold a License No. 021002048 (IL). The NPI Number for Unknown Individual is 1700158227

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700158227
Phone
(309) 691-9100
Address
7314 N WILLOW LAKE CT
Deactivation Date
16 April 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 7314 N WILLOW LAKE CT

    SUITE A

    PEORIA, IL 616148277

    Phone: (309) 691-9100

    Fax: (309) 691-6755

    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 61614)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1700158227 uniquely identifies Unknown Individual in U.S. healthcare data.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Endodontics in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Peoria, 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.

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