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Individual

DR. JAMES KENNETH SMEDEGARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12255 S 80TH AVENUE, SUITE 202, PALOS HEIGHTS, IL 60463
(708) 923-7878
Mailing address
12255 S 80TH AVENUE, SUITE 202, PALOS HEIGHTS, IL 60463
(708) 923-7878

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036071573
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036071573
IL
01
055429
VALUE BEHAVIORAL HEALTH
IL
01
0991516762
BCBS
IL
01
12368
JOHN HANCOCK
IL
01
219043
MAGELLAN
IL
01
260015287
RR MEDICARE
IL
01
363827229
WPS
IL
01
363827229 02
HERITAGE
IL
01
7229P
CATERPILLAR
IL
01
L029112
CHAMPUS
IL
Enumeration date
10/02/2006
Last updated
07/08/2007
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