Individual
DR. KYLA NICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3059 W 26TH ST, CHICAGO, IL 60623
(773) 584-6200
Mailing address
2001 S CALIFORNIA AVE STE 100, CHICAGO, IL 60608-2486
(773) 584-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-128969
IL
2080A0000X
Pediatric Adolescent Medicine Physician
036-128969
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036.128969
—
IL
Enumeration date
03/01/2007
Last updated
09/29/2020
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