Roger Garren Craddock, CCC-SLP in Kewanee, IL - Medicare Speech-Language Pathologist Provider

Roger Garren Craddock, CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in Kewanee, Illinois. His current practice location is 24 Pine Tree Rd, Kewanee, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 854-2522.

Roger Garren Craddock is licensed to practice in Illinois (license number 14431547) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790427805.

Contact Information

	Roger Garren Craddock, CCC-SLP
	24 Pine Tree Rd, Kewanee, IL 61443-9639
	(309) 854-2522
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Roger Garren Craddock
Gender	Male
Speciality	Speech-language Pathologist
Location	24 Pine Tree Rd, Kewanee, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790427805
Provider Enumeration Date: 04/09/2022
Last Update Date: 04/09/2022

Medicare PECOS Information:

PECOS PAC ID: 5294194817
Enrollment ID: I20230629002664

Medical Identifiers

Medical identifiers for Roger Garren Craddock such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790427805	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	14431547 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Roger Garren Craddock allows following entities to bill medicare on his behalf.

Provider Name	Comprehensive Therapeutics Ltd
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1699094102 PECOS PAC ID: 8921230137 Enrollment ID: O20140422000663

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Roger Garren Craddock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Roger Garren Craddock, CCC-SLP 24 Pine Tree Rd, Kewanee, IL 61443-9639 Ph: (309) 854-2522	Roger Garren Craddock, CCC-SLP 24 Pine Tree Rd, Kewanee, IL 61443-9639 Ph: (309) 854-2522

Reviews and Comments

Speech-Language Pathologist in Kewanee, IL

Mrs. Kayla Marie Zima, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1318 W 6th St, Kewanee, IL 61443 Phone: 309-852-5696
Brooke Ann Hickman, M.A. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: Po Box 597, Kewanee, IL 61443 Phone: 309-852-5696
Nichole Dawn Taylor, M.S. CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1318 W 6th St, Kewanee, IL 61443 Phone: 309-852-5696
Ms. Heather Gustafson, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1401 Lake St, Kewanee, IL 61443 Phone: 309-852-2449
Hannah Hutton, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1318 W 6th St, Kewanee, IL 61443 Phone: 309-852-5696
Mrs. Susan Renee Draminski, CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1318 W 6th St, Kewanee, IL 61443 Phone: 309-852-5696
Amanda Brown, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1051 W South St, Kewanee, IL 61443 Phone: 309-852-7500

Roger Garren Craddock, CCC-SLP - Medicare Speech-Language Pathologist in Kewanee, IL