Individual
JACOB SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 N TERRA COTTA RD, CRYSTAL LAKE, IL 60012-1809
(815) 893-6777
Mailing address
1585 RAYMOND DR APT 204, NAPERVILLE, IL 60563-2295
(630) 740-9726
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3295
IL
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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