Individual
CHARELLE OCTAVIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1564 S WASHINGTON ST, DU QUOIN, IL 62832-3849
(618) 542-8702
(618) 542-8792
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2401
(618) 453-1102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.153658
IL
Other
Enumeration date
06/20/2018
Last updated
02/06/2026
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