Smith, Dale M

Smith, Dale M is an sole proprietor health care provider with primary practice located at 5405 W 95Th St , Oak Lawn IL 60453-2349. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Smith, Dale M can be contacted via phone (708) 425-7476.

Contact Information

Primary practice address
5405 W 95Th St Oak Lawn IL 60453-2349
Phone: (708) 425-7476
Fax: (708) 425-4223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016002624 Illinois
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1831197052
LBN Legal business name Smith, Dale M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated Jan 21st, 2014 - 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 1831197052 NPPES
Illinois MEDICAID 016002624

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