Crossroads Physicians Corp
LBN: Crossroads Physicians Corp
Crossroads Physicians Corp is an health care organization with primary practice located at 209 Crossroads Pl Suite 110, Mount Vernon IL 62864-6254. The organization recently has 7 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Rural Health, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Crossroads Physicians Corp can be contacted via phone (618) 244-6710, or through Brewer, Debbie T via phone (615) 465-7626.
Contact Information
Primary practice address
209 Crossroads Pl Suite 110
Mount Vernon IL 62864-6254
Phone: (618) 244-6710
Fax: (618) 244-6779
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ||
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X |
Profile Details
| NPI number | 1508850520 |
|---|---|
| LBN Legal business name | Crossroads Physicians Corp |
| DBA Doing business as | |
| Authorized official | Brewer, Debbie T |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 6th, 2005 |
| Last updated | Aug 25th, 2009 - about 13 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 | 1508850520 | NPPES |
| Illinois | MEDICAID | 036064567 | |
| Illinois | Other | 4132020 |
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