Individual
MS. DEBORAH A SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53 W JACKSON BLVD STE 510, CHICAGO, IL 60604-3434
(312) 600-0876
Mailing address
53 W JACKSON BLVD STE 510, CHICAGO, IL 60604-3434
(312) 600-0876
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NA
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S56316152871
DRIVERS LICENSE
IL
Enumeration date
06/28/2021
Last updated
06/28/2021
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