Individual
NAKEISHA N SMYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8419 S COTTAGE GROVE AVE, CHICAGO, IL 60619-6113
(773) 651-0200
(773) 651-8968
Mailing address
1930 PARK WEST BLVD APT 1D, GRIFFITH, IN 46319-1239
(708) 916-4246
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XOG901421935
—
IL
Enumeration date
12/04/2018
Last updated
12/04/2018
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