NPIMap

Individual provider Active NPI

David J Crandall, M.D.

  • Obstetrics & Gynecology Physician
  • Lake Barrington, IL
National Provider Identifier
1033195383
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-078801 Issued in IL
Practice address
22N285 Pepper Rd
Suite #111
Lake Barrington, IL 60010-5982
Phone
(847) 382-7330
Fax
(847) 382-9654
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-078801 IL Primary

Addresses

Primary practice location

22N285 Pepper Rd
Suite #111
Lake Barrington, IL 60010-5982

Mailing address

22N285 Pepper Rd
Suite #111
Lake Barrington, IL 60010-5982
Phone (847) 382-7330

Other identifiers 4

IdentifierTypeStateIssuer
036078801OtherILBLUE CROSS BLUE SHIELD
036078801MedicaidIL
50703OtherILADVOCATE PHO
160019098OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922000014 IL Practitioner - Obstetrics/Gynecology 6305814435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Iowa, RJ & L Carver College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Barrington Womens Health Center PCGroup PAC ID 0840268975, 4 clinicians

Practice addresses (Care Compare)

22285 N Pepper Rd
Ste111
Lake Barrington, IL 60010-2539

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-078801ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Barrington Womens Health Center PC CurrentSince Jun 1, 2004 Accepting new patients
Lake Barrington Women'S Health Center, PC Past Accepting new patients
Mobile Anesthesiologists Chicago LLC Past Accepting new patients

Locations

2298 County Line Rd
Algonquin, IL 60102
Phone (847) 854-8542

22285 N Pepper Rd
Ste 111
Lake Barrington, IL 60010
Phone (708) 382-7330

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61178
  • FHIR API: https://fhir4.healow.com/fhir/r4/EBFCDD/Endpoint/EBFCDD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1033195383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22N285 PEPPER RD",
            "address_2": "SUITE #111",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600105982",
            "telephone_number": "847-382-7330",
            "fax_number": "847-382-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22N285 PEPPER RD",
            "address_2": "SUITE #111",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600105982",
            "telephone_number": "847-382-7330",
            "fax_number": "847-382-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-078801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "036078801",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078801",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE PHO",
            "identifier": "50703",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160019098",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Barrington, IL

Sources for this page

Verify at the official NPI Registry.