Individual
TANYA L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
503 WOODS MANOR DR, FREEBURG, IL 62243-4073
(618) 539-9888
Mailing address
503 WOODS MANOR DR, FREEBURG, IL 62243-4073
(618) 539-9888
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164.002959
IL
133V00000X
Registered Dietitian
Primary
2004017627
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861674871
ADVANCED MEDICIAL SOLUTIONS, LLC D/B/A INSIGHT DIETITIANS
MO
01
—
IL5797
ADVANCED MEDICAL SOLUTIONS, LLC MEDICARE PIN
IL
01
—
MA 2877
ADVANCED MEDICAL SOLUTIONS, LLC MEDICARE PIN
MO
Enumeration date
09/11/2008
Last updated
10/21/2013
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