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 1780678797

Crossroads Physician Corp is a Family Medicine 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.

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Practice location Address checks out

209 Crossroads Pl Ste 120
Mount Vernon, IL 62864-6254
Phone: (618) 242-3119
Fax: (618) 242-3132
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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)

Record details

NPI number1780678797
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCrossroads Physician Corp
Authorized official Debbie Brewer — Director Of Provider Enrollment · (615) 465-7626
Other names Crossroads Family Associates #1
NPI enumeratedSeptember 6, 2005
Last updated in NPPESJanuary 2, 2008
Mailing address209 Crossroads Pl, Suite 120, Mount Vernon, IL 62864-6254

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