Individual provider Active NPI

Richard A Craig, DDS

  • General Practice Dentistry
  • Lockport, IL
National Provider Identifier
1124041769
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019014284 Issued in 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
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019014284ILMDGeneral Practice Dentistry

Practice roles

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

Organizations & group practices 9

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1124041769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14831 W 159TH ST STE 1",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604919008",
            "telephone_number": "312-676-9892",
            "fax_number": "815-744-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14831 W 159TH ST STE 1",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604919008",
            "telephone_number": "815-483-2980",
            "fax_number": "815-744-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019014284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

Verify at the official NPI Registry.