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1093070211 NPI number — PAMELA E SMITH MD MPH CHES SC

NPI Number: 1093070211
Health Care Provider/Practitioner: PAMELA E SMITH MD MPH CHES SC

Information about “1093070211” NPI (PAMELA E SMITH MD MPH CHES SC) exists in 1093070211 in HTML format HTML  |  1093070211 in plain Text format TXT  |  1093070211 in PDF (Portable Document Format) PDF  |  1093070211 in an XML format XML  formats.

NPI Number : 1093070211 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093070211",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PAMELA E SMITH MD MPH CHES SC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1950 S AVERS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60623-2450",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-490-8842",
    "MailingAddressFaxNumber": "773-277-0027",
    "FirstLinePracticeLocationAddress": "2701 W 68TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60629-1813",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-884-7920",
    "PracticeLocationAddressFaxNumber": "773-884-8065",
    "EnumerationDate": "07/13/2012",
    "LastUpdateDate": "07/13/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMITH",
    "AuthorizedOfficialFirstName": "PAMELA",
    "AuthorizedOfficialMiddleName": "ELEASHIA",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "773-490-8842",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207V00000X",
        "TaxonomyName": "Obstetrics & Gynecology Physician",
        "LicenseNumber": "036062316",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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