Provider Demographics
NPI:1154526291
Name:CRAIG, LORI L
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:L
Other - Last Name:CUFFEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 FALCON CREST DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:61858-9573
Mailing Address - Country:US
Mailing Address - Phone:217-649-1459
Mailing Address - Fax:
Practice Address - Street 1:620 WARRINGTON AVENUE
Practice Address - Street 2:COLONIAL MANOR
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-6183
Practice Address - Country:US
Practice Address - Phone:217-446-0660
Practice Address - Fax:847-441-0734
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.008263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070-008263OtherSTATE LICENSE