Individual
BENJAMIN SMITH-DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-3296
(708) 684-3142
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-3296
(708) 684-3142
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125056466
IL
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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