Individual
CORNELIUS K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 859-8700
Mailing address
1870 W GALENA BLVD, AURORA, IL 60506-4356
(630) 859-6700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-057706
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057706
—
IL
01
—
P00921
INDIVIDUAL MEDICARE #
—
Enumeration date
07/14/2006
Last updated
05/12/2011
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