MARK D CROCKETT M.D. NPI 1073542403

NPI Information

  • NPI: 1073542403
  • Provider Name: MARK D CROCKETT, M.D.
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • Address: 150 W HIGH ST
    MORRIS, IL
    ZIP 60450
  • Phone: (815) 942-2932

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NPI Details

Mark D Crockett, M.D. is an emergency medicine in Morris, IL. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Mark D Crockett, M.D. NPI is 1073542403. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

150 W HIGH ST
MORRIS, IL
ZIP 60450-463
Phone: (815) 942-2932

The enumeration date for this NPI number is 6/30/2006 and was last updated on 6/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine036091397ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G19156MEDICARE UPINILLINOIS
2L81376MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
3930096984OTHERILLINOISRAILROAD MEDICARE
40360913973MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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