Individual
DR. FREDERICK A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 N CHILDRENS PLZ, PATHOLOGY MB17, CHICAGO, IL 60614-3363
(773) 880-4000
Mailing address
2300 N CHILDRENS PLZ, BOX 17, CHICAGO, IL 60614-3363
(773) 880-4000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0104X
Chemical Pathology Physician
Primary
036062613
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062613
—
IL
Enumeration date
07/29/2005
Last updated
10/24/2011
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