Active NPI
Richard Neal Craig, AUD
- Military Health Care Provider
- Marion, IL
National Provider Identifier
1376704783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 147000639
- Practice address
- 2401 W Main St
VA Medical Center
Marion, IL 62959-1188 - Phone
- (618) 997-5311
- NPI assigned
- Jun 18, 2008
- Last updated
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 147000639 | IL | Primary |
Addresses
Primary practice location
2401 W Main St
VA Medical Center
Marion, IL 62959-1188
Mailing address
1807 Hardy Street
Eldorado, IL 62930
Phone (618) 997-5311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147000639 | IL | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1376704783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1807 HARDY STREET",
"city": "ELDORADO",
"state": "IL",
"postal_code": "62930",
"telephone_number": "618-997-5311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"address_2": "VA MEDICAL CENTER",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-997-5311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "RICHARD",
"middle_name": "NEAL",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "IL",
"license": "147000639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.