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NPI Code Detail

MEDICARE: LATANYA CRAIG

MEDICARE:   LATANYA  CRAIG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant242.001506IL
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1346551017
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATANYA CRAIG
Provider Business Mailing Address
First Line : 3420 S COTTAGE GROVE AVE APT 809
Second Line :
City : CHICAGO
State : IL
Zip : 60616-5119
Country : US
Telephone Number : 773-988-6215
Fax Number :
Provider Business Practice Location Address
First Line : 3420 S COTTAGE GROVE AVE APT 809
Second Line :
City : CHICAGO
State : IL
Zip : 60616-5119
Country : US
Telephone Number : 773-988-6215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2010
Last Update Date : 06/24/2011

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Directions to “ LATANYA CRAIG ” Practice Location

Language Start Address Practice Location
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