Individual
BRIAN A SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
430 PENNSYLVANIA AVE, GLEN ELLYN, IL 60137-4464
(630) 469-9200
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
036101688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101688
—
IL
Enumeration date
03/23/2006
Last updated
08/22/2023
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