Active NPI
Vein & Esthetic Centre
- Vascular Surgery Physician
- Carterville, IL
National Provider Identifier
1184850752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- VEIN & ESTHETIC CENTRE
- Practice address
- 10419 Fleming Rd
Carterville, IL 62918-3391 - Phone
- (573) 651-1882
- Fax
- (573) 334-5302
- NPI assigned
- Jun 9, 2009
- Organization subpart
- Yes
- Parent organization
- VEIN & ESTHETIC CENTRE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John Thomas Critchlow, M.D.
- Title
- Owner/Manager
- Phone
- (573) 651-1882
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | Primary |
Addresses
Primary practice location
10419 Fleming Rd
Carterville, IL 62918-3391
Mailing address
3065 William St
Suite 105
Cape Girardeau, MO 63703-6393
Phone (573) 651-1882
National Provider Directory
National Provider Directory- Tax ID family
- Veinesthetic Centre
- Part of
- Veinesthetic Centre
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Vascular Surgery Physician
- Poplar Bluff, MO
- NPI 1093941668
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Cape Girardeau, MO
- NPI 1326108945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1244505600000",
"number": "1184850752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3065 WILLIAM ST",
"address_2": "SUITE 105",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637036393",
"telephone_number": "573-651-1882",
"fax_number": "573-334-5302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10419 FLEMING RD",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629183391",
"telephone_number": "573-651-1882",
"fax_number": "573-334-5302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VEIN & ESTHETIC CENTRE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VEIN & ESTHETIC CENTRE",
"enumeration_date": "2009-06-09",
"last_updated": "2009-06-09",
"status": "A",
"authorized_official_last_name": "CRITCHLOW",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "OWNER/MANAGER",
"authorized_official_telephone_number": "573-651-1882",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carterville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.