Individual
DR. CARLEIGH VANDETTA-SMITHERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1845 OAK ST, NORTHFIELD, IL 60093-3022
(847) 386-6560
Mailing address
5 JEAN TER, LAKE ZURICH, IL 60047-1215
(847) 323-1356
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
052012852
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056012852
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
01/27/2020
Last updated
01/27/2020
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