Active NPI
Susan E Crawford, D.O.
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
National Provider Identifier
1194725341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 036079326
- Practice address
- Teresa Camp, Northwestern Faculty FDN, Prov Enrollment
680 Lakeshore Drive, Suite #1000
Chicago, IL 60611 - Phone
- (314) 977-4559
- NPI assigned
- Jul 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036079326 | IL | Primary |
Addresses
Primary practice location
Teresa Camp, Northwestern Faculty FDN, Prov Enrollment
680 Lakeshore Drive, Suite #1000
Chicago, IL 60611
Mailing address
Teresa Camp, Northwestern Faculty FDN, Prov Enrollment
680 Lakeshore Drive, Suite #1000
Chicago, IL 60611
Phone (314) 977-4559
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036079326 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036079326 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1194725341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "TERESA CAMP, NORTHWESTERN FACULTY FDN, PROV ENROLLMENT",
"address_2": "680 LAKESHORE DRIVE, SUITE #1000",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "314-977-4559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TERESA CAMP, NORTHWESTERN FACULTY FDN, PROV ENROLLMENT",
"address_2": "680 LAKESHORE DRIVE, SUITE #1000",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "314-977-4559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "SUSAN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-29",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "036079326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036079326",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.