Thayer, Craig B

Thayer, Craig B is an individual health care provider with primary practice located at 3249 Oak Park Ave , Berwyn IL 60402-3429. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Thayer, Craig B can be contacted via phone (708) 783-2696.

Contact Information

Primary practice address
3249 Oak Park Ave Berwyn IL 60402-3429
Phone: (708) 783-2696
Fax: (708) 783-3164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X Illinois

Profile Details

NPI number 1124067293
LBN Legal business name Thayer, Craig B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Feb 14th, 2008 - about 17 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 1124067293 NPPES
Illinois MEDICAID 036056389 3

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