Individual
GARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
97 OLDE ENGLISH, ROMEOVILLE, IL 60446
(630) 640-4058
Mailing address
PO BOX 4462, LISLE, IL 60532-9462
(630) 640-4058
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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