Unknown Individual – Geriatric Medicine (Internal Medicine) Physician, NPI 1922034834

Unknown Individual is a healthcare provider. based in Crystal lake, Illinois. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold a License No. 036059446 (IL). The NPI Number for Unknown Individual is 1922034834

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1922034834
Phone
(815) 356-5176
Address
4220 WEATHERSTONE RD
Deactivation Date
20 April 2021
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

  • 4220 WEATHERSTONE RD

    CRYSTAL LAKE, IL 600144521

    Phone: (815) 356-5176

    Type: Mailing

  • Alexian Brothers Medical Center, 800, Biesterfield Road, Elk Grove Village, Elk Grove Township, Cook County, Illinois, 60007, United States

    SUITE 605

    ELK GROVE VILLAGE, IL 600073311

    Phone: (847) 364-6724

    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.

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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 ·

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 60014)

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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 1922034834.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Crystal Lake?
Unknown Individual currently maps to Crystal Lake, Illinois in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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