Provider Demographics
NPI:1881074078
Name:LABBATE, CRAIG V (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:V
Last Name:LABBATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 PARK AVE W STE B100
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2469
Mailing Address - Country:US
Mailing Address - Phone:847-503-3000
Mailing Address - Fax:847-503-3500
Practice Address - Street 1:767 PARK AVE W STE B100
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2469
Practice Address - Country:US
Practice Address - Phone:847-503-3000
Practice Address - Fax:847-503-3500
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036145233208800000X
TXS9923208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX426940902OtherCSHCN
TX426940901Medicaid