Doctor Name: | EDWARD D SMITH |
NPI Number: | 1013928829 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY D |
License Number: | |
Business Practice Address: | 7 Salt Creek Ln Suite 206 Hinsdale, IL - 605212927 |
Business Phone Number: | 6308502120 |
Business Fax Number: | 6308502123 |
Mailing Address: | 7 Salt Creek Ln, Suite 206 HINSDALE |
State: | IL |
Postal Code: | 605212927 |
Phone Number: | 6308502120 |
Fax Number: | 6308502123 |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |