Healthcare Provider Details

I. General information

NPI: 1144258948
Provider Name (Legal Business Name): CHRISTOPHER ANDREW SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHN H STROGER JR HOSPITAL OF COOK COUNTY 1901 W HARRISON STREET
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

5402 S UNIVERSITY AVE
CHICAGO IL
60615-5108
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-7231
  • Fax:
Mailing address:
  • Phone: 773-667-7615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: