# MR.OAK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164917720
- **Authorized official:** DR. STEVEN SMITH MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (312) 259-8555

## Contact information

- **Practice address:** 3510 W 79TH ST, CHICAGO, IL 60652-1430
- **Practice address phone:** (312) 259-8555
- **Practice address fax:** (773) 978-0705
- **Mailing address:** 1629 S PRAIRIE AVE UNIT 1108, CHICAGO, IL 60616-5059
- **Mailing address phone:** (312) 259-8555
- **Mailing address fax:** (773) 978-0705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 06/26/2018
- **Last updated:** 06/26/2018