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NPI Code Detail

MEDICARE: MICHELLE SMEKENS RD

MEDICARE:   MICHELLE  SMEKENS  RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175F00000XNaturopath10-1222AZ
2133V00000XRegistered Dietitian164007177IL

General Provider Information

NPI Number : 1326605247
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE SMEKENS RD
Provider Business Mailing Address
First Line : 37194 N DILLON CT
Second Line :
City : LAKE VILLA
State : IL
Zip : 60046-1702
Country : US
Telephone Number : 224-643-7174
Fax Number :
Provider Business Practice Location Address
First Line : 200 GREEN BAY RD FL 2
Second Line :
City : HIGHWOOD
State : IL
Zip : 60040-1703
Country : US
Telephone Number : 847-235-2139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2019
Last Update Date : 05/19/2022

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Directions to “ MICHELLE SMEKENS RD” Practice Location

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