Craig, Megan

Craig, Megan is an individual health care provider with primary practice located at 809 W Detweiller Dr Suite 805A, Peoria IL 61615-2149. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Craig, Megan can be contacted via phone (309) 692-1320.

Contact Information

Primary practice address
809 W Detweiller Dr Suite 805A Peoria IL 61615-2149
Phone: (309) 692-1320
Fax: (309) 692-1355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 19-027169 Illinois

Profile Details

NPI number 1588718506
LBN Legal business name Craig, Megan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588718506 NPPES
Illinois MEDICAID 9185445

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