Provider Demographics
NPI:1306362389
Name:RAINO, CRAIGORY JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIGORY
Middle Name:JAMES
Last Name:RAINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15012 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1960
Mailing Address - Country:US
Mailing Address - Phone:815-260-4396
Mailing Address - Fax:
Practice Address - Street 1:2901 PLAINFIELD RD STE A
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-1129
Practice Address - Country:US
Practice Address - Phone:815-260-4396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0313551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice