Individual
SMITHA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3003 WAKEFIELD DR, CARPENTERSVILLE, IL 60110-2422
(708) 747-7100
Mailing address
PO BOX 19656, SPRINGFIELD, IL 62794-9656
(217) 545-8853
(217) 545-0828
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125-052368
IL
Other
Enumeration date
08/17/2007
Last updated
12/19/2012
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