Individual
MICHAEL J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 N RANDALL RD, ELGIN, IL 60123-2300
(224) 783-6873
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036-159215
IL
2085R0001X
Radiation Oncology Physician
Primary
224998
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2113384
—
MA
01
—
494427
TUFTS HEALTH PLAN
MA
01
—
AA49033
HARVARD PILGRIM
MA
01
—
J29581
BLUE SHIELD
MA
Enumeration date
07/27/2006
Last updated
11/16/2022
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