Individual
DR. RUTH A. CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1801 WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-5434
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-5434
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036077138
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077138
—
IL
01
—
173355
PERSONAL CARE
IL
Enumeration date
03/15/2006
Last updated
10/06/2015
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