Provider Demographics
NPI:1992096911
Name:CRISWELL, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:CRISWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E OHIO ST
Mailing Address - Street 2:APT 28E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3390
Mailing Address - Country:US
Mailing Address - Phone:415-272-4011
Mailing Address - Fax:
Practice Address - Street 1:420 E OHIO ST
Practice Address - Street 2:APT 28E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3390
Practice Address - Country:US
Practice Address - Phone:415-272-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist