Unknown Individual – Specialist, NPI 1790787570

Unknown Individual is a healthcare provider. based in Gurnee, Illinois. specializing in Specialist. The NPI Number for Unknown Individual is 1790787570

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790787570
Phone
(847) 856-2534
Address
1445 N HUNT CLUB RD
Deactivation Date
14 February 2024
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

  • 1445, North Hunt Club Road, Gurnee, Lake, Illinois, 60031, United States

    SUITE 103

    GURNEE, IL 600312603

    Phone: (847) 856-2534

    Fax: (847) 856-8254

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $138.

Total Amount is formed as General ($138) + Research ($0) + Ownership ($0) = $138.

Last reported payment date: 2024-04-06 • Largest payer in this snapshot: Johnson & Johnson Surgical Vision, Inc. ($138).

Total Amount

$138

General + Research + Ownership

Payments

1

Total payment records

General Amount

$138

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 60031)

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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 1790787570.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Other Service Providers. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Gurnee?
Public fields place Unknown Individual around Gurnee, Illinois. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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