Crossroads Physician Corporation
LBN: Crossroads Physician Corporation
Crossroads Physician Corporation is an health care organization with primary practice located at 1245 S Mill St , Nashville IL 62263-2004. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Crossroads Physician Corporation can be contacted via phone (618) 327-9333, or through Brewer, Debbie T via phone (615) 465-7626.
Contact Information
Primary practice address
1245 S Mill St
Nashville IL 62263-2004
Phone: (618) 327-9333
Fax: (618) 327-9022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Illinois | |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | Illinois |
Profile Details
| NPI number | 1629063698 |
|---|---|
| LBN Legal business name | Crossroads Physician Corporation |
| DBA Doing business as | |
| Authorized official | Brewer, Debbie T |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Apr 27th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629063698 | NPPES |
| Illinois | MEDICAID | 036052179 |
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