Paul C Jacobs Trevor Crabtree PTR

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

046-008310 Issued in IL

Legal business name

PAUL C JACOBS TREVOR CRABTREE PTR

Doing business as

Jacobs & Crabtree Dctrs of Optometry

Practice address

223 N Park Ave
Herrin, IL 62948-3149

Phone

(618) 942-6887

Fax

(618) 988-1209

NPI assigned

Jun 20, 2007

Last updated

Dec 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn Sue Keller

Title

Office Manager

Phone

(618) 993-8787

Specialties & licenses 1

Addresses

Other names 1

• JACOBS & CRABTREE DCTRS OF OPTOMETRY Doing business as

Locations

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1649475328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 SIOUX DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595200",
            "telephone_number": "618-993-8787",
            "fax_number": "618-997-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483149",
            "telephone_number": "618-942-6887",
            "fax_number": "618-988-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL C JACOBS TREVOR CRABTREE PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "618-993-8787"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046-008310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACOBS & CRABTREE DCTRS OF OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaily Marie Palmer, PT
• Carolyn Dale Pape, P.T.
• Elizabeth Parrilli
• Kirsten Elisabeth Parrish, OTR/L
• Sarah Elizabeth Patula, RBT
• Mary Jolynn Pentecost, PTA
• Rollin Morris Perkins IV, PA-C
• Kimberly Anne Peters, OT
• Rachel Peterson, PT
• Angelique Petree

• Corneal and Contact Management Optometrist in Herrin, IL
• Providers in Herrin, IL by specialty
• Corneal and Contact Management Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.