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Individual

CHASE ALAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
332 S MICHIGAN AVE STE 900, CHICAGO, IL 60604-4393
(855) 832-6727
Mailing address
3001 N CHURCH ST, ROCKFORD, IL 61103-3135
(815) 980-3788

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IL

Other

Enumeration date
05/14/2025
Last updated
05/14/2025
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