Provider Demographics
NPI:1528188018
Name:MCCALL, CRAIG CARLTON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:CARLTON
Last Name:MCCALL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S WACKER DR
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-7413
Mailing Address - Country:US
Mailing Address - Phone:312-263-1018
Mailing Address - Fax:312-466-5601
Practice Address - Street 1:1500 WAUKEGAN RD
Practice Address - Street 2:SUITE 213
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2100
Practice Address - Country:US
Practice Address - Phone:312-263-1018
Practice Address - Fax:312-466-5601
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005951103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1043459324OtherGROUP NPI NUMBER