Individual
MRS. MOLLY MORGAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2070 IL-50 #500, BOURBONNAIS, IL 60914
(779) 236-4094
Mailing address
779 W ADAMS ST, CHICAGO, IL 60661-3509
(779) 236-4094
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041427975
IL
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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