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Crossroads Physician Corp

Crossroads Physician Corp is a healthcare organization registered as Rural Health Clinic/Center in Mount Vernon, IL, holding Type 2 (organization) NPI 1669466686 since 2005. The authorized official on file is Debbie Brewer, Director of Provider Enrollment.

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NPI 1669466686
Entity type Organization (Type 2)
Legal business name Crossroads Physician Corp
Other name <Unavail>
Parent organization Crossroads Physician Corp
Practice address 3505 BROADWAY ST, Mount Vernon, IL, 62864
Phone 6182418772
Fax 6182418775
Enumeration date 2005-09-06
Last updated in NPPES 2011-08-10

Authorized official

Name Debbie Brewer
Title Director of Provider Enrollment
Phone 6154657626

Taxonomy & classification

Taxonomy code Specialty Primary License State
261QR1300X Rural Health Clinic/Center Primary

Other identifiers

Identifier Type State Issuer
036041176 Medicaid IL
Copy-ready billing details
Provider: Crossroads Physician Corp
NPI: 1669466686
Taxonomy: 261QR1300X (Rural Health Clinic/Center)
Address: 3505 BROADWAY ST, Mount Vernon, IL, 62864

Providers at this address

NPI Name Type Specialty Location
1558473645 John Hall, M.D., P.C. Organization Adult Medicine Physician Mount Vernon, IL
1023235348 Anderson Family Practice Organization Primary Care Clinic/Center Mount Vernon, IL
1639019169 Mt. Vernon Chiropractic Clinic, Pllc Organization Chiropractor Mount Vernon, IL

Verify this record

Cross-check NPI 1669466686 against the authoritative CMS record: view Crossroads Physician Corp on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Crossroads Physician Corp located?
The practice location on file with NPPES is in Mount Vernon, IL.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2011-08-10. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-08-10.