Provider Demographics
NPI:1205925872
Name:CROFOOT, NEIL A (OD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:A
Last Name:CROFOOT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E GOLF RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4442
Mailing Address - Country:US
Mailing Address - Phone:847-781-1022
Mailing Address - Fax:847-781-1021
Practice Address - Street 1:520 E GOLF RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4442
Practice Address - Country:US
Practice Address - Phone:847-781-1022
Practice Address - Fax:847-781-1021
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist