Individual
CRAIG A BACKS
Active
Individual
CRAIG A BACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036065128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008546
HEALTH ALLIANCE
IL
01
—
020057300
BLACK LUNG
IL
05
—
036065128
—
IL
01
—
08421024
BLUE CROSS BLUE SHIELD
IL
01
—
100364
HEALTHLINK
IL
01
—
110201127
RR MEDICARE PIN
IL
01
—
133586700
ACS-OWCP
IL
01
—
14D0949277
CLIA CERT
IL
01
—
170765
PERSONAL CARE
IL
01
—
6394P
CATERPILLAR
IL
01
—
CD7143
RR MEDICARE GRP
IL
Enumeration date
07/12/2006
Last updated
09/22/2011
Update your record
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