Unknown Individual – Cardiovascular Disease Physician, NPI 1790776250

Unknown Individual is a healthcare provider. based in Homewood, Illinois. specializing in Cardiovascular Disease Physician. The NPI Number for Unknown Individual is 1790776250

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790776250
Phone
(708) 799-0180
Address
17901 GOVERNORS HWY
Deactivation Date
11 March 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

  • 17901, Governors Highway, Homewood, Bremen Township, Cook County, Illinois, 60430, United States

    SUITE 101

    HOMEWOOD, IL 604301144

    Phone: (708) 799-0180

    Fax: (708) 799-3839

    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 60430)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1790776250.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Homewood, Illinois?
For routing, start with Homewood, Illinois for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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