Provider Demographics
NPI:1821158825
Name:CRAIG W. MILLARD, D.D.S., P.C.
Entity Type:Organization
Organization Name:CRAIG W. MILLARD, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-726-5830
Mailing Address - Street 1:30 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 920
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-726-5830
Mailing Address - Fax:312-726-7290
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:SUITE 920
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-726-5830
Practice Address - Fax:312-726-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty