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Crossroads Physician Corp

Crossroads Physician Corp is a healthcare organization registered as Internal Medicine Physician in Mount Vernon, IL, holding Type 2 (organization) NPI 1790779874 since 2005. The authorized official on file is Debbie Brewer, Director of Provider Enrollment.

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NPI 1790779874
Entity type Organization (Type 2)
Legal business name Crossroads Physician Corp
Other name <Unavail>
Parent organization Crossroads Physician Corp
Practice address 4101 N WATER TOWER PL, Mount Vernon, IL, 62864
Phone 6182444313
Fax 6182449592
Enumeration date 2005-09-06
Last updated in NPPES 2007-10-30

Authorized official

Name Debbie Brewer
Title Director of Provider Enrollment
Phone 6154657626

Taxonomy & classification

Taxonomy code Specialty Primary License State
363L00000X Nurse Practitioner Secondary IL
207R00000X Internal Medicine Physician Primary IL
Copy-ready billing details
Provider: Crossroads Physician Corp
NPI: 1790779874
Taxonomy: 207R00000X (Internal Medicine Physician)
Address: 4101 N WATER TOWER PL, Mount Vernon, IL, 62864

Providers at this address

NPI Name Type Specialty Location
1578513420 William Huffstutler Individual Internal Medicine Physician Mount Vernon, IL
1528233681 Megan Neely Individual Internal Medicine Physician Mount Vernon, IL
1558685156 Johanna Estes Individual Family Nurse Practitioner Mount Vernon, IL
1255724043 National Healthcare of Mt. Vernon, Inc Organization Internal Medicine Physician Mount Vernon, IL
1841785185 Cynthia Phillips Individual Nurse Practitioner Mount Vernon, IL
1447814405 National Healthcare of Mt Vernon Inc Organization Rural Health Clinic/Center Mount Vernon, IL
1962023820 Paul Lane Individual Physician Assistant Mount Vernon, IL
1316663602 Deaconess Illinois Crossroads Inc Organization Rural Health Clinic/Center Mount Vernon, IL

Verify this record

Cross-check NPI 1790779874 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 a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Crossroads Physician Corp?
Crossroads Physician Corp is registered in NPPES as a Internal Medicine Physician (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-10-30.