Individual
KENDRA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 S MICHIGAN AVE, CHICAGO, IL 60616-2315
(312) 567-2000
Mailing address
22302 W KANKAKEE RIVER DR, WILMINGTON, IL 60481-8803
(772) 502-7152
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018531
IL
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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