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General NPI Number Information
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NPI Number | 1427444785
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Entity Type | Organization
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Legal Business Name | DR SJ SMITHERMAN TOTAL HEALTH SOLUTIONS, SC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 200 E ROOSEVELT RD BUCHHOLZ 202
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City | LOMBARD
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State | IL
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Zip | 60148-4539
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Country | US
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Telephone | 872-222-5776
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Fax | 206-278-8225
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Provider Business Mailing Address
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Address Line | 200 E ROOSEVELT RD BUCHHOLZ 202
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City | LOMBARD
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State | IL
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Zip | 60148-4539
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Country | US
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Telephone | 872-222-5776
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Fax | 206-278-8225
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. STEPHEN JUSTIN SMITHERMAN
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Credential | DC
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Telephone | 872-222-5776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 038012763
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License Number State | IL
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