Provider Demographics
NPI:1679318000
Name:CRAWFORD, ANNIKA CHRISTINE (OD)
Entity type:Individual
Prefix:DR
First Name:ANNIKA
Middle Name:CHRISTINE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-1846
Mailing Address - Country:US
Mailing Address - Phone:847-395-4090
Mailing Address - Fax:
Practice Address - Street 1:31 NORTH AVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1846
Practice Address - Country:US
Practice Address - Phone:847-395-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011856152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist