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

Jack Dyer Crouch III

Individual provider Dermatology Physician · NPI 1215772033

Jack Dyer Crouch III is a Dermatology Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2024.

Licensed in
IL
In the registry since
2024

Practice location Address checks out

4646 N Marine Dr
Chicago, IL 60640-5759
Phone: (773) 564-5225
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 125.084866 (IL)

Record details

NPI number1215772033
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 25, 2024
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024
Mailing address4646 N Marine Dr, Chicago, IL 60640-5759

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