Individual
LATASHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
958 N PARKSIDE AVE, CHICAGO, IL 60651-2652
(773) 407-3237
Mailing address
958 N PARKSIDE AVE, CHICAGO, IL 60651-2652
(773) 407-3237
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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