Unknown Individual – Gastroenterology Physician, NPI 1962436378

Unknown Individual is a healthcare provider. based in Homewood, Illinois. specializing in Gastroenterology Physician. They hold a License No. 036051101 (IL). The NPI Number for Unknown Individual is 1962436378

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1962436378
Phone
(708) 799-3305
Address
17901 GOVERNORS HWY
Deactivation Date
19 April 2023
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

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

    SUITE 208

    HOMEWOOD, IL 604301144

    Phone: (708) 799-3305

    Fax: (708) 799-7220

    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

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1962436378; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Homewood, Illinois for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1962436378. Always confirm identity and privileges with the practice and licensing boards.

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