Unknown Individual – Family Medicine Physician, NPI 1740239045

Unknown Individual is a healthcare provider. based in Bolingbrook, Illinois. specializing in Family Medicine Physician. They hold a License No. 36036866 (IL). The NPI Number for Unknown Individual is 1740239045

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1740239045
Phone
(708) 245-8900
Address
PO BOX 7009
Deactivation Date
12 February 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

  • Bolingbrook Post Office, 105, Canterbury Lane, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604407009

    Phone: (708) 245-8900

    Fax: (708) 245-5604

    Type: Mailing

  • Adventist La Grange Memorial Hospital, 5101, Willow Springs Road, La Grange, Lyons Township, Cook County, Illinois, 60525, United States

    2ND FLR

    LA GRANGE, IL 605252600

    Phone: (708) 245-8900

    Fax: (708) 245-5604

    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.

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 60440)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1740239045.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Bolingbrook, Illinois in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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