MEDICARE: STEVEN C SMART MD

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
1	207RC0000X	Cardiovascular Disease Physician	32148	WI
2	207RC0000X	Cardiovascular Disease Physician	36548	IA
3	207RC0000X	Cardiovascular Disease Physician	48319	MN
4	207RC0000X	Cardiovascular Disease Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669476545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN C SMART MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-2000
Fax Number	:	847-570-2937

Provider Business Practice Location Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-2000
Fax Number	:	847-570-2937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	03/28/2008

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Directions to “ STEVEN C SMART MD” Practice Location

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