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Organization
PAMELA E SMITH MD MPH CHES SC
Active
Organization
PAMELA E SMITH MD MPH CHES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA ELISE SMITH MD (PRESIDENT)
(773) 542-0517
Entity
Organization
Contact information
Practice address
1950 S AVERS AVE, CHICAGO, IL 60623-2450
(773) 542-0517
(773) 522-3637
Mailing address
1950 S AVERS AVE, CHICAGO, IL 60623-2450
(773) 542-0517
(773) 522-3637
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036062316
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
036062316
IL
207VB0002X
Obesity Medicine (Obstetrics & Gynecology) Physician
036062316
IL
2083P0901X
Public Health & General Preventive Medicine Physician
036062316
IL
2085U0001X
Diagnostic Ultrasound Physician
036062316
IL
208D00000X
General Practice Physician
036062316
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062316
—
IL
01
—
C42702
UPIN
IL
Enumeration date
10/28/2008
Last updated
10/28/2008
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