Individual
LISA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2025 S CHICAGO ST, JOLIET, IL 60436-3172
(815) 726-2200
Mailing address
1409 EDMONDS AVE, NEW LENOX, IL 60451-1896
(708) 518-9280
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018093
IL
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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