Provider Demographics
NPI:1659248250
Name:CRAIG, MADISON (MED, NCC, QMHP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MED, NCC, QMHP
Other - Prefix:
Other - First Name:MADI
Other - Middle Name:
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, NCC, QMHP
Mailing Address - Street 1:3955 N LAMON AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2736
Mailing Address - Country:US
Mailing Address - Phone:251-586-4771
Mailing Address - Fax:
Practice Address - Street 1:3445 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4420
Practice Address - Country:US
Practice Address - Phone:773-777-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health