Individual
TAMARA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
525 E. GRANT STREET, OUTPATIENT SERVICES SUITE, MACOMB, IL 61455
(309) 836-6937
(309) 836-6530
Mailing address
525 E. GRANT STREET, OUT PATIENT SERVICES SUITE, MACOMB, IL 61455
(309) 836-6937
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-126160
IL
207V00000X
Obstetrics & Gynecology Physician
20A6984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX69840
—
CA
05
—
100122074
—
CA
Enumeration date
08/05/2006
Last updated
01/15/2025
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