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General NPI Number Information
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NPI Number | 1932923901
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Entity Type | Organization
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Legal Business Name | SMITH'S RELIABLE SCREENING SOLUTIONS
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 19710 GOVERNORS HWY STE 5
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City | FLOSSMOOR
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State | IL
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Zip | 60422-2081
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Country | US
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Telephone | 815-531-7208
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Fax | 708-794-3666
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Provider Business Mailing Address
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Address Line | 19710 GOVERNORS HWY STE 5
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City | FLOSSMOOR
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State | IL
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Zip | 60422-2081
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Country | US
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Telephone | 815-531-7208
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Fax | 708-794-3666
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Authorized Official
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Title or Position | CEO
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Name | TIESHA TRICE
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Credential |
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Telephone | 815-531-7208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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