Craig V Svoboda, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036076253 Issued in IL

Practice address

607 4TH St
Eldorado Rural Health Clinic
Eldorado, IL 62930

Phone

(618) 273-2951

Fax

(618) 273-2712

NPI assigned

Sep 20, 2006

Last updated

Oct 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Pekin Prohealth Inc

  • Family Medicine Physician
  • Pekin, IL
  • NPI 1932150299
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1699873117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "address_2": "REA CINIC",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 4TH ST",
            "address_2": "ELDORADO RURAL HEALTH CLINIC",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "62930",
            "telephone_number": "618-273-2951",
            "fax_number": "618-273-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVOBODA",
        "first_name": "CRAIG",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036076253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Stone
• Stress & Trauma Treatment Center
• Stress & Trauma Treatment Center, Inc.
• Deborah S Sullivan, FNP-C
• Gretchen L Sutton, P.A.
• Octavia Swango, MSW
• Ahmed Ali Tariq, DO
• Tonya Dea Taylor, LCSW
• Jessica Lynne Tepe
• Franko Gilbert Teston

• Family Medicine Physician in Eldorado, IL
• Providers in Eldorado, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.