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Contact Information

CATHARINE J CROCKETT, MD
1505 EASTLAND DR
STE 2200
BLOOMINGTON, IL61701-7910
 Phone: 309-662-7700
 Fax: 309-662-0829
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for CATHARINE J CROCKETT · (Female)

NPI Number 1295739746
Status Active
Credentials MD
Entity Individual
Enumeration date 06/10/2005
Last updated 10/24/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036084217
  • IL Medicaid 036084217
  • IL Other 05700231 BC/BS PROVIDER #
Hospital affiliation(s)
  • ST JOSEPH MEDICAL CENTER - (Acute Care)
    2200 E WASHINGTON
    BLOOMINGTON, IL 61701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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