Provider Demographics
NPI:1588661607
Name:CONOVER, CRAIG SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:SCOTT
Last Name:CONOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:122 SOUTH MICHIGAN AVENUE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603
Mailing Address - Country:US
Mailing Address - Phone:312-814-4846
Mailing Address - Fax:312-814-4844
Practice Address - Street 1:122 S MICHIGAN AVE
Practice Address - Street 2:7S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6191
Practice Address - Country:US
Practice Address - Phone:312-814-4846
Practice Address - Fax:312-814-4844
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036091623207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE35284Medicare UPIN