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Organization

PAMELA E SMITH MD MPH CHES SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA ELEASHIA SMITH MD (PRESIDENT)
(773) 490-8842
Entity
Organization

Contact information

Practice address
2701 W 68TH ST, CHICAGO, IL 60629-1813
(773) 884-7920
(773) 884-8065
Mailing address
1950 S AVERS AVE, CHICAGO, IL 60623-2450
(773) 490-8842
(773) 277-0027

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036062316
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036062316
IL
Enumeration date
07/13/2012
Last updated
07/13/2012
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