Organization
FUNCTIONAL REGENERATIVE SERVICES OF ILLINOIS LTD LLC
Active
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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