Healthcare Provider Details

I. General information

NPI: 1992192546
Provider Name (Legal Business Name): KAYLEE N CRAIGO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27650 FERRY RD STE 100
WARRENVILLE IL
60555-3846
US

IV. Provider business mailing address

27650 FERRY RD STE 100
WARRENVILLE IL
60555-3846
US

V. Phone/Fax

Practice location:
  • Phone: 630-225-2663
  • Fax: 630-225-2399
Mailing address:
  • Phone: 630-225-2663
  • Fax: 630-225-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085009654
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: