Individual
DR. CHARLES SMITTKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1901
(217) 544-6464
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(097) 404-2723
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
036125189
IL
2085N0700X
Neuroradiology Physician
40110
IA
2085R0202X
Diagnostic Radiology Physician
Primary
125-052437
IL
Other
Enumeration date
08/17/2007
Last updated
01/03/2024
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