Unknown Individual – Physical Therapist, NPI 1790019057

Unknown Individual is a healthcare provider. based in West frankfort, Illinois. specializing in Physical Therapist. They hold a License No. 070.006141 (IL). The NPI Number for Unknown Individual is 1790019057

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790019057
Phone
Not provided
Address
308 W 5TH ST
Deactivation Date
4 September 2025
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

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Provider Addresses for Unknown Individual

  • 308, West 5th Street, West Frankfort, Franklin County, Illinois, 62896, United States

    WEST FRANKFORT, IL 628962032

    Phone:

    Type: Mailing

  • 2907, Williamson County Parkway, Marion, Williamson County, Illinois, 62959, United States

    MARION, IL 629595256

    Phone: (618) 998-9894

    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 62896)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1790019057?
NPI 1790019057 belongs to Unknown Individual; compare other details if you need extra assurance.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use West Frankfort, Illinois as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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