DR. CARROLL EDWARD SMITH M.D. NPI 1386784346

NPI Information

NPI: 1386784346
Provider Name: DR. CARROLL EDWARD SMITH, M.D.
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

Address:
4215 S KING DR
CHICAGO, IL
ZIP 60653
Phone: (773) 624-0366
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DR. Carroll Edward Smith, M.D. is an adult medicine family medicine in Chicago, IL. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. DR. Carroll Edward Smith, M.D. NPI is 1386784346. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4215 S KING DR
CHICAGO, IL
ZIP 60653-663
Phone: (773) 624-0366
Fax: (773) 624-0367

The enumeration date for this NPI number is 2/7/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	036-36570	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036-36570	OTHER	ILLINOIS	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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