Unknown Individual – Clinical Psychologist, NPI 1760506265

Unknown Individual is a healthcare provider. based in Lake forest, Illinois. specializing in Clinical Psychologist. They hold a License No. 071.002108 (IL). The NPI Number for Unknown Individual is 1760506265

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1760506265
Phone
(847) 234-8606
Address
579 RYAN PL
Deactivation Date
22 October 2021
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

Provider Addresses for Unknown Individual

  • 579 RYAN PL

    POBOX 71

    LAKE FOREST, IL 600452436

    Phone: (847) 234-8606

    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.

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60045)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1760506265.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Lake Forest, Illinois.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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