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Organization

ALLERGY & ASTHMA OF ILLINOIS SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN J SMART MD (PRESIDENT)
(309) 691-5200
Entity
Organization

Contact information

Practice address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 691-5200
(309) 691-5201
Mailing address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 691-5200
(309) 691-5201

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
042008003
IL

Other

Enumeration date
09/30/2005
Last updated
01/26/2010
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