Individual
MS. JONNELLE D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
523 S MAIN ST, CARROLLTON, IL 62016-1256
(217) 942-3326
(217) 942-9833
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
085 002986
IL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
01/21/2021
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