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Organization

FUNCTIONAL REGENERATIVE SERVICES OF ILLINOIS LTD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINA NICOLE SMITH APRN-FNP-C (NURSE PRACTITIONER)
(217) 253-2370
Entity
Organization

Contact information

Practice address
902 S COURT STREET, SUITE 2, TUSCOLA, IL 61953
(217) 253-2370
Mailing address
902 S COURT STREET, SUITE 2, TUSCOLA, IL 61953
(217) 253-2370

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
04/14/2021
Last updated
06/03/2021
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