OrganizationActive
Crossroads Physician Corp
NPI 1417941436 · Surgery Physician · Mount Vernon, IL
Crossroads Physician Corp is a Surgery Physician organization in Mount Vernon, IL (NPI 1417941436).
Provider details
- NPI number
- 1417941436
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Crossroads Physician Corp
- Organization subpart
- Yes
- Authorized official
- Debbie Brewer, Director of Provider Enrollment(615) 465-7626
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
209 Crossroads Pl
Suite 130
Mount Vernon, IL 62864-6254
Phone: (618) 242-3831
Fax: (618) 242-3375
Street-level locationGet directions
Mailing address
209 Crossroads Pl
Mount Vernon, IL 62864-6254
Other names (DBA / former)
- Doing business as
- Crossroads Surgical Associates
Registry dates
- Enumerated
- 2005-09-06
- Last updated
- 2007-10-30
Frequently asked questions
- What is Crossroads Physician Corp's NPI number?
- Crossroads Physician Corp's National Provider Identifier (NPI) is 1417941436, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crossroads Physician Corp?
- Crossroads Physician Corp is classified in the NPPES registry as Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Crossroads Physician Corp located?
- Crossroads Physician Corp's practice location on file with NPPES is 209 Crossroads Pl, Mount Vernon, IL 62864-6254.
- What is Crossroads Physician Corp's phone number?
- The practice phone number listed in the NPPES registry for Crossroads Physician Corp is (618) 242-3831.
- Who is the authorized official for Crossroads Physician Corp?
- The authorized official listed on Crossroads Physician Corp's NPPES record is Debbie Brewer, Director of Provider Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crossroads Physician Corp's NPI active?
- Yes — Crossroads Physician Corp's NPI (1417941436) is active in the NPPES registry as of the last update on 2007-10-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.