Individual
MATT R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(815) 280-9937
Mailing address
2019 FOX HVN, CHATHAM, IL 62629-4411
(815) 209-9937
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
05128656
IL
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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