Individual
MRS. CYNTHIA SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, ACNP
Contact information
Practice address
1095 PINGREE RD, SUITE 108, CRYSTAL LAKE, IL 60014-1726
(815) 459-6655
(847) 658-9922
Mailing address
1095 PINGREE RD, SUITE 108, CRYSTAL LAKE, IL 60014-1726
(815) 459-6655
(847) 658-9922
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209-001572
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-291329
IL REGISTERED NURSE
IL
01
—
209-001572
ADVANCED PRACTICE NURSE
IL
01
—
309-001579
IL SUBSCRIBER
IL
Enumeration date
07/20/2006
Last updated
08/24/2023
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