Provider Demographics
NPI:1295165439
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:<UNAVAIL>
Other - Org Type:
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 1:27790 W HIGHWAY 22
Practice Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 2
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2340
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:2013-11-26
Last Update Date:2025-01-10
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
1750599494OtherNPI KATHRYN VALCARENGHI DDS
1447468178OtherNPI IVAN VALCARENGHI DDS
1790843399OtherNPI ANGELA PLANER VENEGONI DDS
1053423285OtherNPI KEVIN WALLACE DMD
1265442073OtherNPI BRIAN PRENTICE DDS
1053431981OtherNPI GROUP
6472260004OtherMEDICARE NSC
1265538458OtherNPI JONATHAN S LOWN MD