Individual
DR. KERRY E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
55 E WASHINGTON ST, SUITE 733, CHICAGO, IL 60602-2103
(312) 419-0016
(312) 422-1008
Mailing address
55 E WASHINGTON ST, SUITE 733, CHICAGO, IL 60602-2103
(312) 419-0016
(312) 422-1008
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627462
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/22/2006
Last updated
07/08/2007
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