Healthcare Provider Details

I. General information

NPI: 1952422248
Provider Name (Legal Business Name): JOHN GEORGE CRAWFORD III D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S MAIN ST STE 271
NAPERVILLE IL
60540-8044
US

IV. Provider business mailing address

37352 S MACKS RD
CUSTER PARK IL
60481-8426
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-6960
  • Fax:
Mailing address:
  • Phone: 708-790-9788
  • Fax: 708-524-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number021.000832
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number021.000939
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12013818A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: