Individual
DR. EARL C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608-1732
(773) 257-6730
Mailing address
26460 NETWORK PL, CHICAGO, IL 60674-0035
(708) 786-2900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-042187
IL
207RN0300X
Nephrology Physician
Primary
036-042187
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-042187-2
—
IL
01
—
L35338
MEDICARE PTAN
—
Enumeration date
08/02/2005
Last updated
01/08/2015
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