Individual
LONNETTA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1316 W 112TH PL, CHICAGO, IL 60643-4404
(717) 668-4312
Mailing address
1316 W 112TH PL, CHICAGO, IL 60643-4404
(717) 668-4312
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
IL
Other
Enumeration date
07/09/2022
Last updated
07/09/2022
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