Smith, Earl C

Smith, Earl C is an individual health care provider with primary practice located at 1501 S California Ave , Chicago IL 60608-1732. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Smith, Earl C can be contacted via phone (773) 257-6730.

Contact Information

Primary practice address
1501 S California Ave Chicago IL 60608-1732
Phone: (773) 257-6730
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-042187 Illinois
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036-042187 Illinois

Profile Details

NPI number 1760483614
LBN Legal business name Smith, Earl C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jan 8th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760483614 NPPES
Other L35338 MEDICARE PTAN
MEDICAID 036-042187-2 MEDICARE PTAN

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