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Individual
SHANI KAMARIA SMITH
Active
Individual
SHANI KAMARIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O., M.B.A.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036.130820
IL
207R00000X
Internal Medicine Physician
Primary
036.130820
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036.130820
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F00280905
MEDICARE IL PTAN
IL
Enumeration date
12/21/2010
Last updated
07/28/2021
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