Richard A Craig, DDS

Individual provider Active NPI General Practice Dentistry · Lockport, IL

NPI 1124041769 · NPPES record last updated Jan 19, 2021

Key facts

NPI
1124041769
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
019014284 (IL)
Practice address
14831 W 159TH St Ste 1
Lockport, IL 60491-9008
Phone
(815) 483-2980
Fax
(815) 744-7059
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060505000359 IL Practitioner - Dentist
Practitioner - Oral Surgery
6507877537 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Sleep Center Richard a Craig DDS LTD General Practice Current
since Sep 27, 2010
Accepting new patients
Dental Sleep Center Richard a Craig DDS LTD General Practice Current Accepting new patients
Dental Sleep Center Richard a Craig DDS LTD General Practice Current
since Sep 29, 2010
Accepting new patients
Shorewood Family Dental Care LLP General Practice Past Accepting new patients
Compliant Sleep Solutions-Converging Sleep Networks LLC Past
since Sep 27, 2010
Accepting new patients

Locations

27790 W Il Route 22
Ste 2
Barrington, IL 60010
Phone (630) 218-1920

150 E Huron St
Ste 1103
Chicago, IL 60611
Phone (312) 676-9893

14831 W 159th St
Ste 1
Lockport, IL 60491
Phone (312) 676-9893

2500 S Highland Ave
Ste 220
Lombard, IL 60148
Phone (630) 218-1920

220 Channahon St
Shorewood, IL 60404
Phone (630) 218-1920

4711 Golf Rd
Ste 413
Skokie, IL 60076
Phone (847) 329-9588

4711 Golf Rd
Ste 912
Skokie, IL 60076
Phone (847) 676-3500

7501 Lemont Rd
Ste 300
Woodridge, IL 60517
Phone 6303245369105

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019014284 IL Yes

Addresses

Primary practice location

14831 W 159TH St Ste 1
Lockport, IL 60491-9008

Mailing address

14831 W 159TH St Ste 1
Lockport, IL 60491-9008
Phone (312) 676-9892

Other identifiers

IdentifierTypeStateIssuer
1053431981OtherGROUP NPI
1205145554OtherPRACTICE LOCATION TYPE II NPI
1295165439OtherPRACTICE LOCATION TYPE II NPI
1063649770OtherGROUP NPI
1760882005OtherPRACTICE LOCATION TYPE II NPI
1306177241OtherPRACTICE LOCATION TYPE II NPI
1508198474OtherPRACTICE LOCATION TYPE II NPI

Other providers in Lockport, IL

All providers in Lockport, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.