| |
14831 W 159th St Ste 1 Homer Glen IL 60491-9008 | |
(815) 483-2980 | |
(815) 744-7059 |
Full Name | |
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Speciality | Clinic/Center |
Location | 14831 W 159th St Ste 1, Homer Glen, Illinois |
Authorized Official Name and Position | Richard Allen Craig (PRESIDENT) |
Authorized Official Contact | 8154832980 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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14831 W 159th St Ste 1 Lockport IL 60491-9008 Ph: (312) 676-9893 | 14831 W 159th St Ste 1 Homer Glen IL 60491-9008 Ph: (815) 483-2980 |
NPI Number | 1205145554 |
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Provider Enumeration Date | 10/05/2010 |
Last Update Date | 01/10/2025 |
Medicare PECOS PAC ID | 8820287121 |
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Medicare Enrollment ID | O20110118000436 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205145554 | NPI | - | NPPES |
1053431981 | Other | NPI GROUP | |
1790843399 | Other | NPI ANGELA PLANER VENEGONI DDS | |
1265442073 | Other | NPI BRIAN PRENTICE DDS | |
1053423285 | Other | NPI KEVIN WALLACE DMD | |
1124041769 | Other | NPI RICHARD CRAIG DDS | |
1265538458 | Other | NPI JONATHAN LOWN MD | |
1447468178 | Other | NPI IVAN VALCARENGHI DDS | |
1750599494 | Other | NPI KATHRYN VALCARENGHI DDS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Earley Family Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15748 S Bell Rd, Homer Glen, IL 60491 Phone: 708-301-2220 Fax: 708-301-2194 | |
Mary Ellen Hoye Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15927 South Bell Road, Homer Glen, IL 60491 Phone: 708-301-3444 Fax: 708-301-6066 | |
Homer-lockport Dental Associates, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12701 W 143rd St, Homer Glen, IL 60491 Phone: 708-301-3800 | |
Sheryl Leipold D.d.s. P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15927 S Bell Rd, Homer Glen, IL 60491 Phone: 708-645-0505 Fax: 708-301-6066 | |
Kasper,heaton,wright,pagni,andassociates,ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13161 W 143rd St, Suite 104, Homer Glen, IL 60491 Phone: 708-301-1930 Fax: 708-301-1939 |