Individual
CASEY PATRICK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4445 W IRVING PARK RD STE 320, CHICAGO, IL 60641
(312) 926-3627
(312) 921-1002
Mailing address
929 W WOLFRAM ST APT 1, CHICAGO, IL 60657-5096
(248) 835-7336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036165695
IL
Other
Enumeration date
03/27/2020
Last updated
11/21/2023
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