Individual
CHRISTINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12701 W 143RD ST STE 200, HOMER GLEN, IL 60491-7723
(877) 694-7722
Mailing address
12701 W 143RD ST STE 200, HOMER GLEN, IL 60491-7723
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
041313453
IL
Other
Enumeration date
11/13/2013
Last updated
03/09/2017
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