Individual
DR. ROMAN M SMYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
460 N BROADWAY ST, COAL CITY, IL 60416-1045
(815) 634-2592
(815) 634-4052
Mailing address
35 E WILLOW ST STE B, COAL CITY, IL 60416-1869
(815) 634-3048
(815) 634-8188
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036066804
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03606684
—
IL
01
—
040002092
RAILROAD MEDICARE
IL
01
—
3200048
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/12/2006
Last updated
04/20/2011
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