Individual
DR. LESLIE L SIMONTON-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8 CUSUMANO PROFESSIONAL PLAZA DR, MOUNT VERNON, IL 62864-6736
(618) 244-4800
(618) 241-1746
Mailing address
8 CUSUMANO PROFESSIONAL PLAZA DR, MOUNT VERNON, IL 62864-6736
(618) 244-4800
(618) 241-1746
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036069531
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069531
—
IL
01
—
117129
HEALTHLINK
IL
01
—
160050341
RAILROAD MEDICARE
IL
01
—
4126930
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/25/2006
Last updated
03/07/2014
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