| Craig a Backs MD LLC | |
|
2921 Greenbriar Dr Suite C Springfield IL 62704-6421 | |
| (217) 321-1987 | |
| (866) 594-7830 |
| Full Name | Craig a Backs MD LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2921 Greenbriar Dr, Springfield, Illinois |
| Authorized Official Name and Position | Craig Backs (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2173211987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig a Backs MD LLC 2921 Greenbriar Dr Suite C Springfield IL 62704-6421 Ph: (217) 321-1987 | Craig a Backs MD LLC 2921 Greenbriar Dr Suite C Springfield IL 62704-6421 Ph: (217) 321-1987 |
| NPI Number | 1235421603 |
|---|---|
| Provider Enumeration Date | 05/04/2011 |
| Last Update Date | 05/04/2011 |
| Medicare PECOS PAC ID | 7810173747 |
|---|---|
| Medicare Enrollment ID | O20110510000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235421603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 248000028 (Illinois) | Primary |
| Provider Name | Craig a Backs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124043252 PECOS PAC ID: 0941276026 Enrollment ID: I20040909000634 |
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