Individual
TODD R. SMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2202 HARLEM RD, SUITE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM RD, SUITE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.010628
IL
Other
Enumeration date
08/15/2013
Last updated
02/03/2014
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