Provider Demographics
NPI:1235462854
Name:CRAIG, DANIEL G (MA, OTR/L, MT-BC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:CRAIG
Suffix:
Gender:M
Credentials:MA, OTR/L, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6033 N SHERIDAN RD
Mailing Address - Street 2:#22E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3003
Mailing Address - Country:US
Mailing Address - Phone:708-927-9319
Mailing Address - Fax:
Practice Address - Street 1:6033 N SHERIDAN RD
Practice Address - Street 2:#22E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3003
Practice Address - Country:US
Practice Address - Phone:708-927-9319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL08585225A00000X
IL056.007751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist