Individual
JOHANNA SUZANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
328 N ILLINOIS AVE, APT A, VILLA PARK, IL 60181-2108
(262) 951-8020
Mailing address
328 N ILLINOIS AVE, APT A, VILLA PARK, IL 60181-2108
(262) 951-8020
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041431571
IL
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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