Provider Demographics
NPI:1295840767
Name:ANDRESEN, CRAIG A (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:ANDRESEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 ALFT LN STE 100
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-7843
Mailing Address - Country:US
Mailing Address - Phone:847-888-3383
Mailing Address - Fax:847-888-3332
Practice Address - Street 1:2410 ALFT LN STE 100
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-7843
Practice Address - Country:US
Practice Address - Phone:847-888-3383
Practice Address - Fax:847-888-3332
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor