Provider Demographics
NPI:1083748420
Name:CRAIG, CATHERINE M (CNM)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:CRAIG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 COPPERFIELD AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-2054
Mailing Address - Country:US
Mailing Address - Phone:815-727-1887
Mailing Address - Fax:
Practice Address - Street 1:1301 COPPERFIELD AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2054
Practice Address - Country:US
Practice Address - Phone:815-727-1887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife