DR. LAURA ANN CRANDALL (NPI# 1477767101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477767101 |
| Entity Type | Individual |
| Full Name | DR. LAURA ANN CRANDALL |
| Credential | D.O. |
| Practice Address |
1167 Fortune Blvd Shiloh IL 62269-7377 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 6182076900 |
| Practice Fax Number | 6182076901 |
| Mailing Telephone | 6182076900 |
| Mailing Fax Number | 6182076901 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036-1380876 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 5101016265 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023444817 | Laura Ann Crandall | Physical Therapist | 267 Park St, Montclair, NJ 07043-1732 | 2013-09-24 |
| 1477168748 | Laura Jill Crandall | Occupational Therapist | 1400 N Locust St, Denton, TX 76201-3040 | 2020-09-13 |
| 1043416233 | Laura L. Crandall | Physical Therapist | 115 Medical Dr Ste 105, Victoria, TX 77904-3105 | 2007-06-25 |
| 1134340151 | Laura Jane Crandall | Family Medicine | 280 Henry St, New York, NY 10002-4816 | 2007-05-01 |
| 1316081888 | Laura Susan Crandall | Speech-Language Pathologist | 402 91st Ave Ne, Everett, WA 98205-1530 | 2007-02-17 |
| Street Address |
1167 FORTUNE BLVD |
| City | SHILOH |
| State | IL |
| Zip Code | 62269-7377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861902025 | Kayla J Mccarthy | Registered Nurse | 1167 Fortune Blvd, Shiloh, IL 62269 | 2017-10-02 |
| 1023497591 | Gaylin Manion | Nurse Practitioner | 1167 Fortune Blvd, Shiloh, IL 62269-7377 | 2015-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447416342 | Muhammad Farooq Asghar | Internal Medicine | 1404 Cross St Ste 2114, Shiloh, IL 62269-2988 | 2008-07-31 |
| 1881117125 | Pc Associates, LLC | Internal Medicine | 1414 Cross St Ste 230, Shiloh, IL 62269-2988 | 2017-07-19 |
| 1942542931 | Michael Gerard Guignon Jr. | Internal Medicine | 1414 Cross St Ste 230, Shiloh, IL 62269 | 2013-03-18 |
| 1003904269 | Dickson Inc | Internal Medicine | 851 Main St, Shiloh, NJ 08353-8505 | 2006-10-11 |
| 1851314017 | Robert W Dickson IIi | Internal Medicine | 851 Main St, Shiloh, NJ 08353-8505 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002832 | Coleman Clinic, Inc. | Internal Medicine | 1893 Daimler Rd Ste A, Rockford, IL 61112-1081 | 2020-10-29 |
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1447866579 | Jashan Gill | Internal Medicine | 3707 Doty Rd Ste Eandf, Woodstock, IL 60098-7530 | 2020-09-23 |
| 1649884636 | Maria Detolve Donoghue | Internal Medicine | 905 Eldorado St, Winnetka, IL 60093-1951 | 2020-09-07 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1659989937 | Consultant Physicians | Internal Medicine | 580 Bankview Dr, Frankfort, IL 60423-1382 | 2020-07-22 |
| 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.