Individual provider · NPI-1
Dr. Stephen J Smart, MD
Allergy & Immunology · Peoria, IL
NPI number1265429625
StatusActive
Last updated in NPPESJul 8, 2021
Details
- NPI
- 1265429625
- Entity type
- Individual (NPI-1)
- Name
- Dr. Stephen J Smart
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2005
- Certification date
- Jul 8, 2021
- Last updated
- Jul 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207K00000X | Allergy & Immunology | 036092320 | IL | Yes |
Practice location
6615 N Big Hollow RdPeoria, IL 61615-2450
Phone 309-691-5200 · Fax 309-691-5201
Mailing address
Po Box 19248Springfield, IL 62794-9248
Phone 217-528-7541 · Fax 309-691-5201
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