Provider Demographics
NPI:1760882005
Name:DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
Entity Type:Organization
Organization Name:DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
Other - Org Name:MIDWEST DENTAL SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-676-9892
Mailing Address - Street 1:14831 W 159TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60491-9008
Mailing Address - Country:US
Mailing Address - Phone:312-676-9893
Mailing Address - Fax:815-744-7059
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:SUITE 413
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:312-676-9892
Practice Address - Fax:815-744-7059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-22
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124041769OtherNPI RICHARD CRAIG DDS
647226005OtherMEDICARE NSC
1053453936OtherNPI STEVEN MORAVEC DDS
1750599494OtherNPI KATHRYN VALCARENGHI DDS
1265442073OtherNPI BRIAN PRENTICE DDS
1447468174OtherNPI IVAN VALCARENGHI DDS
1053423285OtherNPI KEVIN WALLACE DMD
1053431981OtherNPI GROUP
1265538458OtherNPI JONATHAN S LOWN MD