1780023549 NPI number — MRS. CLAIRE MARIE SMOLINSKI LMT

Table of content: MRS. CLAIRE MARIE SMOLINSKI LMT (NPI 1780023549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780023549 NPI number — MRS. CLAIRE MARIE SMOLINSKI LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMOLINSKI
Provider First Name:
CLAIRE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAVY
Provider Other First Name:
CLAIRE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780023549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4015 LIBERTY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMONT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60559-1331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-272-7915
Provider Business Mailing Address Fax Number:
630-653-2220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4513 LINCOLN AVE
Provider Second Line Business Practice Location Address:
SUITE 203B
Provider Business Practice Location Address City Name:
LISLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-272-7915
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  227.006378 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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