Crestwood Associated Medical Center Ltd
NPI 1104341163 · Family Medicine Physician · Crestwood, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Crestwood Associated Medical Center Ltd is a Family Medicine Physician organization in Crestwood, IL (NPI 1104341163).
Provider details
- NPI number
- 1104341163
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Revello, President(708) 385-4416
- License
- 038010310 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Chiropractic Providers
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-08-10
- Last updated
- 2022-07-21
Frequently asked questions
- What is Crestwood Associated Medical Center Ltd's NPI number?
- Crestwood Associated Medical Center Ltd's National Provider Identifier (NPI) is 1104341163, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crestwood Associated Medical Center Ltd?
- Crestwood Associated Medical Center Ltd is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Crestwood Associated Medical Center Ltd located?
- Crestwood Associated Medical Center Ltd's practice location on file with NPPES is 13705 Cicero Ave, Crestwood, IL 60418-1824.
- What is Crestwood Associated Medical Center Ltd's phone number?
- The practice phone number listed in the NPPES registry for Crestwood Associated Medical Center Ltd is (708) 385-4416.
- Does Crestwood Associated Medical Center Ltd accept Medicare?
- Crestwood Associated Medical Center Ltd is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Crestwood Associated Medical Center Ltd?
- The authorized official listed on Crestwood Associated Medical Center Ltd's NPPES record is John Revello, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crestwood Associated Medical Center Ltd's NPI active?
- Yes — Crestwood Associated Medical Center Ltd's NPI (1104341163) is active in the NPPES registry as of the last update on 2022-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.