MEDICARE: DR. CRAIG SCOTT CONOVER M.D.

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
1	207R00000X	Internal Medicine Physician	036091623	IL
2	207RI0200X	Infectious Disease Physician	036091623	IL

General Provider Information

NPI Number	:	1588661607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG SCOTT CONOVER M.D.

Provider Business Mailing Address
First Line	:	122 SOUTH MICHIGAN AVENUE
Second Line	:	7TH FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60603
Country	:	US
Telephone Number	:	312-814-4846
Fax Number	:	312-814-4844

Provider Business Practice Location Address
First Line	:	122 S MICHIGAN AVE
Second Line	:	7S
City	:	CHICAGO
State	:	IL
Zip	:	60603-6191
Country	:	US
Telephone Number	:	312-814-4846
Fax Number	:	312-814-4844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	04/22/2021

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