Provider Demographics
NPI:1821336587
Name:OSWALD, CRAIG WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:WILLIAM
Last Name:OSWALD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3976 W IL ROUTE 22
Mailing Address - Street 2:SUITE D
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047
Mailing Address - Country:US
Mailing Address - Phone:847-550-5220
Mailing Address - Fax:847-550-5224
Practice Address - Street 1:3976 W IL ROUTE 22
Practice Address - Street 2:SUITE D
Practice Address - City:LONG GROVE
Practice Address - State:IL
Practice Address - Zip Code:60047
Practice Address - Country:US
Practice Address - Phone:847-550-5220
Practice Address - Fax:847-550-5224
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor