Organization
MR.OAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN SMITH MD (MEDICAL DIRECTOR)
(312) 259-8555
Entity
Organization
Contact information
Practice address
3510 W 79TH ST, CHICAGO, IL 60652-1430
(312) 259-8555
(773) 978-0705
Mailing address
1629 S PRAIRIE AVE UNIT 1108, CHICAGO, IL 60616-5059
(312) 259-8555
(773) 978-0705
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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