Individual
EMMETT SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18660 GRAPHIC DR, SUITE 100, TINLEY PARK, IL 60477-6260
(708) 263-2000
(708) 263-2024
Mailing address
18660 GRAPHIC DR, SUITE 100, TINLEY PARK, IL 60477-6260
(708) 263-2000
(708) 263-2024
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238000399
SURGICAL ASSISTANT
IL
Enumeration date
02/07/2014
Last updated
02/07/2014
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