Provider Demographics
NPI:1164578605
Name:JOSEPH G. CRAIG DDS., LTD
Entity Type:Organization
Organization Name:JOSEPH G. CRAIG DDS., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-453-4380
Mailing Address - Street 1:17 W CONTI PKWY
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4505
Mailing Address - Country:US
Mailing Address - Phone:708-453-4380
Mailing Address - Fax:708-453-7326
Practice Address - Street 1:17 W CONTI PKWY
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4505
Practice Address - Country:US
Practice Address - Phone:708-453-4380
Practice Address - Fax:708-453-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental