Individual
KALLIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4282 E ROCKTON RD, ROSCOE, IL 61073-7420
(779) 696-9000
Mailing address
6490 SHILOH CLOSE, ROCKFORD, IL 61107-2663
(815) 670-1239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209032512
IL
Other
Enumeration date
06/12/2025
Last updated
06/17/2025
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