Crossroads Physician Corp
Crossroads Physician Corp is a healthcare organization registered as Family Medicine Physician in Mount Vernon, IL, holding Type 2 (organization) NPI 1699769612 since 2005. The authorized official on file is Debbie Brewer, Director of Provider Enrollment.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1699769612 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Crossroads Physician Corp |
| Other name | <Unavail> |
| Parent organization | Crossroads Physician Corp |
| Practice address | 209 CROSSROADS PL, SUITE 150, Mount Vernon, IL, 62864 |
| Phone | 6182446222 |
| Fax | 6182447299 |
| Enumeration date | 2005-09-06 |
| Last updated in NPPES | 2007-09-18 |
Authorized official
| Name | Debbie Brewer |
|---|---|
| Title | Director of Provider Enrollment |
| Phone | 6154657626 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Primary | — | IL |
Copy-ready billing details
Provider: Crossroads Physician Corp NPI: 1699769612 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 209 CROSSROADS PL, SUITE 150, Mount Vernon, IL, 62864
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1780678797 | Crossroads Physician Corp | Organization | Family Medicine Physician | Mount Vernon, IL |
| 1508850520 | Crossroads Physicians Corp | Organization | Family Medicine Physician | Mount Vernon, IL |
| 1417941436 | Crossroads Physician Corp | Organization | Surgery Physician | Mount Vernon, IL |
| 1417909060 | Gary Reagan | Individual | Urology Physician | Mount Vernon, IL |
| 1912959578 | Lawrence Hollander | Individual | Surgery Physician | Mount Vernon, IL |
| 1790725307 | Chirag Dave | Individual | Pulmonary Disease Physician | Mount Vernon, IL |
| 1801806039 | Elizabeth Cox | Individual | Family Medicine Physician | Mount Vernon, IL |
| 1194980516 | Crossroads Physician Corp | Organization | Family Medicine Physician | Mount Vernon, IL |
Verify this record
Cross-check NPI 1699769612 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
What is the NPI number for Crossroads Physician Corp?
Who is the authorized official for Crossroads Physician Corp?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-09-18.