Individual
GABRIELLE ANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10640 165TH ST, ORLAND PARK, IL 60467-8734
(708) 364-0261
Mailing address
10640 165TH ST, ORLAND PARK, IL 60467-8734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007783
IL
363A00000X
Physician Assistant
MA060282
PA
Other
Enumeration date
01/23/2019
Last updated
08/12/2022
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