Individual
CHANTEL LANISE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8088
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8088
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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