Individual
MRS. DIONNE VANESSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 W. CURTIS RD., CHAMPAIGN, IL 61822-9678
(217) 365-6202
(217) 326-0188
Mailing address
303 G H BAKER DR, URBANA, IL 61801-1160
(217) 326-6202
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036138395
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2012
Last updated
08/03/2015
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