Healthcare Provider Details

I. General information

NPI: 1306290044
Provider Name (Legal Business Name): JAMES CROOKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 DEMPSTER ST
PARK RIDGE IL
60068-1110
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 847-318-9300
  • Fax:
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-602-9159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.149023
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0072793
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: