Individual
MAURICE ERICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9839 SOUTH CHARLES STREET, CHICAGO, IL 60643-1205
(773) 750-2282
Mailing address
11005 S MICHIGAN AVE STE 427, CHICAGO, IL 60628-4308
(773) 453-8883
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S53054568009
IL
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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