Individual provider Active NPI

Kathleen K Crawford, MD

  • Anesthesiology Physician
  • Peoria, IL
National Provider Identifier
1780673723
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036097994 Issued in IL
Practice address
8600 N State Route 91
Suite 250
Peoria, IL 61615-9541
Phone
(309) 692-5393
Fax
(309) 692-2583
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036097994 IL Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036097994 IL
Family Medicine Physician 207Q00000X 036097994 IL

Addresses

Primary practice location

8600 N State Route 91
Suite 250
Peoria, IL 61615-9541

Mailing address

8600 N State Route 91
Suite 250
Peoria, IL 61615-9541
Phone (309) 692-5393

Other identifiers 1

IdentifierTypeStateIssuer
036097994MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000495 IL Practitioner - Anesthesiology 4789582529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Louisville School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists SCGroup PAC ID 6305744129, 150 clinicians

Practice addresses (Care Compare)

6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097994ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC Anesthesiology CurrentSince Dec 6, 2020 Accepting new patients
Associated Anesthesiologists, S.C. Anesthesiology CurrentSince Aug 1, 1998 Accepting new patients
Methodist Medical Center of Illinois Anesthesiology CurrentSince Oct 16, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Oct 16, 2018 Accepting new patients

Locations

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1780673723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "address_2": "SUITE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159541",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 N STATE ROUTE 91",
            "address_2": "SUITE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159541",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KATHLEEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036097994",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036097994",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036097994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097994",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.