Individual
CHANEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
205 TIMBERLANE RD, MATTESON, IL 60443-1040
(708) 654-8999
Mailing address
205 TIMBERLANE RD, MATTESON, IL 60443-1040
(708) 654-8999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277.004312
IL
Other
Enumeration date
04/25/2023
Last updated
12/09/2025
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