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

Crossroads Physician Corp

Organization Surgery Physician · NPI 1417941436

Crossroads Physician Corp is a Surgery Physician in Mount Vernon, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

209 Crossroads Pl Ste 130
Mount Vernon, IL 62864-6254
Phone: (618) 242-3831
Fax: (618) 242-3375
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X (IL)

Record details

NPI number1417941436
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCrossroads Physician Corp
Authorized official Debbie Brewer — Director Of Provider Enrollment · (615) 465-7626
Other names Crossroads Surgical Associates
NPI enumeratedSeptember 6, 2005
Last updated in NPPESOctober 30, 2007
Mailing address209 Crossroads Pl, Suite 130, Mount Vernon, IL 62864-6254

Other providers in Mount Vernon