DR. JEFFREY A. CROWHURST (NPI# 1043216625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043216625 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY A. CROWHURST |
| Credential | DPM |
| Practice Address |
1703 Polaris Cir Ottawa IL 61350-1683 |
| Practice Telephone | 8154341900 |
| Practice Fax Number | 8154340933 |
| Mailing Telephone | 8154341900 |
| Mailing Fax Number | 8154340933 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2008-02-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016003179 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 60101269 | 01 |
| IL | 016003179 | 05 | |
| RAILROAD MEDICARE | 480025582 | 01 |
| Street Address |
1703 POLARIS CIR |
| City | OTTAWA |
| State | IL |
| Zip Code | 61350-1683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851841407 | Brittany M Jones Dpm LLC | Podiatrist | 1703 Polaris Cir, Suite 4, Ottawa, IL 61350-1683 | 2016-10-06 |
| 1801233606 | Mark Benavides | Dentist | 1703 Polaris Cir, Suite 3, Ottawa, IL 61350-1683 | 2013-06-03 |
| 1780848911 | Brittany Marie Jones | Podiatrist | 1703 Polaris Cir, Suite 4, Ottawa, IL 61350-1683 | 2008-07-16 |
| 1619146016 | Dr Nicholas M Tabor IIi Dpm | Podiatrist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2008-02-29 |
| 1235201344 | Mark Benavides D.d.s., P.C. | Dentist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2006-11-14 |
| 1235167602 | Thomas Patrick Rooney | Dentist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306336359 | Yulandist Jeannie Brown | Licensed Practical Nurse | 617 Columbus St, Ottawa, IL 61350 | 2018-05-15 |
| 1881071272 | Ashlee Herbold | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1718 N 2525th Rd, Ottawa, IL 61350 | 2015-05-05 |
| 1053702365 | Wanda Rohl | Social Worker | 3735 E 1453 Rd, Ottawa, IL 61350 | 2015-02-09 |
| 1538550868 | Erin Rose Boe | Physical Therapist | 2872 Columbus St, Unit 300, Ottawa, IL 61350 | 2015-02-09 |
| 1346572757 | Rebecca Samolitis | Counselor | 116 W Lafayette St, Suite 8, Ottawa, IL 61350 | 2010-02-10 |
| 1235383266 | Timothy I Miller O.d. P.C. | Optometrist | 107 E. Mckinley Rd., Ottawa, IL 61350 | 2008-11-04 |
| 1427204676 | Leo John Meagher | Counselor | 218 West Madison St, Ottawa, IL 61350 | 2008-08-07 |
| 1598938755 | Radiation Oncology of Northern Illinois LLC | Radiology | 1200 Starfire Dr, Ottawa, IL 61350 | 2008-04-09 |
| 1154538510 | Serenityonwheels, Inc. | Counselor | Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 | 2007-05-16 |
| 1205040904 | Dixie Devry | Occupational Therapist | 2532 Reynolds Manor, Ottawa, IL 61350 | 2007-05-10 |
| Find all providers in zip 61350 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417453168 | Jacob B Goldstein Dpm LLC | Podiatrist | 1402 S Main St, Ottawa, KS 66067-3529 | 2018-04-02 |
| 1619146016 | Dr Nicholas M Tabor IIi Dpm | Podiatrist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2008-02-29 |
| 1861583973 | Sukhantar Dhepyasuvarn | Podiatrist | 116 S Main St, Suite A, Ottawa, KS 66067-2328 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1306452099 | Podiatric Management Systems LLC | Podiatrist | 2 W Talcott Rd Ste 23, Park Ridge, IL 60068-5558 | 2020-09-18 |
| 1073129763 | Podiatric Management Systems LLC | Podiatrist | 4310f W Crystal Lake Rd # F, Mchenry, IL 60050-4208 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1689145898 | S Thomas Sehy D P M L L C | Podiatrist | 213 Nw 10th St Ste B, Fairfield, IL 62837-1219 | 2018-12-16 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1932693744 | Giovanni Incandela | Podiatrist | 700 E Algonquin Rd Unit 2313, Schaumburg, IL 60173-3835 | 2018-06-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.