Crockett, Catharine Jean

Crockett, Catharine Jean is an individual health care provider with primary practice located at 1505 Eastland Dr Ste 2200, Bloomington IL 61701-7910. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Crockett, Catharine Jean can be contacted via phone (309) 662-7700.

Contact Information

Primary practice address
1505 Eastland Dr Ste 2200 Bloomington IL 61701-7910
Phone: (309) 662-7700
Fax: (309) 662-0829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036084217 Illinois

Profile Details

NPI number 1295739746
LBN Legal business name Crockett, Catharine Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Oct 24th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295739746 NPPES
Illinois MEDICAID 036084217
Illinois Other 05700231

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