Unknown Individual – Clinical Social Worker, NPI 1891807558

Unknown Individual is a healthcare provider. based in Mattoon, Illinois. specializing in Clinical Social Worker. They hold a License No. 149001477 (IL). The NPI Number for Unknown Individual is 1891807558

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1891807558
Phone
(217) 238-5700
Address
750 BROADWAY AVE E
Deactivation Date
9 January 2025
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

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Provider Addresses for Unknown Individual

  • Broadway Avenue East, Mattoon, Coles County, Illinois, 61938, United States

    MATTOON, IL 619384610

    Phone: (217) 238-5700

    Fax: (217) 238-5767

    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 61938)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1891807558 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Illinois?
You will see Mattoon, Illinois on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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