Search › Illinois › 104100000X
Debra Crockett
NPI 1538698071 · on the registry since 2017
Practice
- Address
- 16107 La Salle St
South Holland, IL 60473 - Phone
- (800) 361-6880
- Fax
- (708) 845-5505
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-06-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois