Crossroads Physician Corp
NPI 1417941436ActiveOrganization· Surgery· Mount Vernon, IL
Surgery in Mount Vernon, Illinois, registered in NPPES in September 2005, part of Crossroads Physician Corp. The authorized official on file is Debbie T. Brewer, Director Of Provider Enrollment.
Overview
| NPI | 1417941436 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Crossroads Physician Corp |
| NPI issued | Sep 6, 2005 |
| Last updated in NPPES | Oct 30, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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