Individual
JOSEPH SMITH II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
654 E 84TH ST, CHICAGO, IL 60619-5802
(312) 927-1276
Mailing address
654 E 84TH ST, CHICAGO, IL 60619-5802
(312) 927-1276
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6345
AZ
363AM0700X
Medical Physician Assistant
Primary
123456
AZ
Other
Enumeration date
03/18/2016
Last updated
11/12/2025
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