Individual
SUSAN B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190
(630) 933-4700
(630) 933-4427
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190
(630) 933-4700
(630) 933-4427
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209007271
IL
363LA2100X
Acute Care Nurse Practitioner
209007271
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
—
01
—
206147073
MEDICARE PTAN (INDIVIDUAL)
—
Enumeration date
08/03/2010
Last updated
06/22/2018
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