Individual
CANDICE MICHELLE SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3231 EUCLID AVE FL 5, BERWYN, IL 60402-4603
(773) 783-2000
Mailing address
3231 EUCLID AVE FL 5, BERWYN, IL 60402-4603
(773) 783-2000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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