Organization Active NPI

Crockett Construction Incorporated

  • Home Modifications Contractor
  • Bourbonnais, IL
National Provider Identifier
1669342804
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
Legal business name
CROCKETT CONSTRUCTION INCORPORATED
Practice address
1223 N Convent St
Bourbonnais, IL 60914-1005
Phone
(708) 301-8522
NPI assigned
Nov 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Brandon Crockett
Title
President of Operations
Phone
(708) 670-0039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171WH0202X Primary

Addresses

Primary practice location

1223 N Convent St
Bourbonnais, IL 60914-1005

Mailing address

1223 N Convent St
Bourbonnais, IL 60914-1005
Phone (708) 301-8522

National Provider Directory

National Provider Directory

Locations

1223 N Convent St
Bourbonnais, IL 60914
Phone (708) 301-8522

NPI Registry JSON

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

{
    "created_epoch": "1762819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1669342804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141005",
            "telephone_number": "708-301-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141005",
            "telephone_number": "708-301-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT CONSTRUCTION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-11",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "708-670-0039"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.