Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crossroads Physician Corp

Organization Family Medicine Physician · NPI 1194980516

Crossroads Physician Corp is a Family Medicine Physician in Mount Vernon, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008
Specialties on file
3
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

209 Crossroads Pl Ste 140
Mount Vernon, IL 62864-6545
Phone: (618) 241-7207
Fax: (618) 241-7210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (IL)
Internal Medicine Physician Taxonomy 207R00000X (IL)
Nurse Practitioner Taxonomy 363L00000X (IL)

Record details

NPI number1194980516
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debbie Brewer — Director · (615) 465-7626
NPI enumeratedJuly 24, 2008
Last updated in NPPESJuly 28, 2008
Mailing address209 Crossrods Pl, Suite 140, Mount Vernon, IL 62864-6545

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