Individual provider Active NPI

Connie Jean Crawford, O.D.

  • Optometrist
  • Antioch, IL
National Provider Identifier
1811969512
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-0079136 Issued in IL
Practice address
884 Hillside Ave
Antioch, IL 60002-1226
Phone
(847) 395-4090
NPI assigned
Feb 6, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-0079136 IL Primary

Addresses

Primary practice location

884 Hillside Ave
Antioch, IL 60002-1226

Mailing address

395 Capital LN
Gurnee, IL 60031-4496
Phone (847) 548-9077

Other names 1

  • Connie Jean Crawford Other name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000410 IL Practitioner - Optometry 1052587649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Antioch Eye Associates OD PCGroup PAC ID 0345416939, 5 clinicians

Practice addresses (Care Compare)

31 N Ave
Antioch, IL 60002-1846
Phone (847) 395-4090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-0079136ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Antioch Eye Associates OD PC Optometrist CurrentSince Mar 13, 2000 Accepting new patients

Locations

31 North Ave
Antioch, IL 60002
Phone (847) 395-4090

884 Hillside Ave
Antioch, IL 60002
Phone (847) 395-1110

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811969512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 CAPITAL LN",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314496",
            "telephone_number": "847-548-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 HILLSIDE AVE",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021226",
            "telephone_number": "847-395-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "CONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-0079136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "CRAWFORD",
            "middle_name": "JEAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.