Provider Demographics
NPI:1053431981
Name:DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
Entity type:Organization
Organization Name:DENTAL SLEEP CENTER RICHARD A CRAIG DDS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-676-9892
Mailing Address - Street 1:14831 W 159TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60491-9008
Mailing Address - Country:US
Mailing Address - Phone:312-676-9892
Mailing Address - Fax:815-744-7059
Practice Address - Street 1:14831 W 159TH ST STE 1
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-9008
Practice Address - Country:US
Practice Address - Phone:312-676-9892
Practice Address - Fax:815-744-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760882005OtherSKOKIE SVC LOCATION
6472260001OtherMEDICARE NSC
6472260003OtherMEDICARE NSC
1306177241OtherOAK BROOK SVC LOCATION
6472260002OtherMEDICARE NSC
1508198474OtherCHICAGO SVC LOCATION
6472260004OtherMEDICARE NSC
6472260005OtherMEDICARE NSC
1205145554OtherSHOREWOOD SVC LOCATION
1295165439OtherBARRINGTON SVC LOCATION
1295165439OtherBARRINGTON SVC LOCATION
1124041769OtherRICHARD CRAIG, DDS
1760882005OtherSKOKIE SVC LOCATION
6472260002OtherMEDICARE NSC