Unknown Individual – Ophthalmology Physician, NPI 1790746469

Unknown Individual is a healthcare provider. based in Merrionette park, Illinois. specializing in Ophthalmology Physician. The NPI Number for Unknown Individual is 1790746469

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790746469
Phone
(708) 388-4400
Address
11600 S KEDZIE AVE
Deactivation Date
16 November 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • South Kedzie Avenue, Mount Greenwood, Merrionette Park, Lake Township, Cook County, Illinois, 60655, United States

    MERRIONETTE PARK, IL 60803

    Phone: (708) 388-4400

    Fax: (708) 389-8484

    Type: Location

  • 183rd Street, Homewood, Thornton Township, Cook County, Illinois, 60430, United States

    HOMEWOOD, IL 60430

    Phone: (708) 798-6633

    Fax: (708) 798-6790

    Type: Mailing

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

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 ·

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

Insurance plans in this area (ZIP 60803)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1790746469 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Merrionette Park, Illinois?
For routing, start with Merrionette Park, Illinois for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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