Provider Demographics
NPI:1962533927
Name:PIETERS, CRAIG HAYDEN (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HAYDEN
Last Name:PIETERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:389 ROBINWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 N. WINFIELD RD
Practice Address - Street 2:CENTRAL DUPAGE HOSPITAL DIAGNOSTIC IMAGING
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-933-4240
Practice Address - Fax:630-933-2675
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0643162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE18848Medicare UPIN