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Physician Compare National (NPI:1093709057)

HEALTHCARE PROVIDER: JOHN MARTIN CROWE JR. M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1093709057
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0345324018
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20080220000364
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CROWE
Individual professional last name
Provider First Name JOHN
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 2001
Individual professional's medical school graduation year
Primary Specialty FAMILY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 EMERGENCY MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties EMERGENCY MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name RED BUD PHYSICIAN GROUP LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 0648454520
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 4
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 325 SPRING ST
Group Practice or individual's line 1 address
City RED BUD
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 622781105
Group Practice or individual's zip code (9 digits when available)
Phone Number 6182823831
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 141348
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 RED BUD REGIONAL HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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