NPI 1134198211

Kimberly Ann Smith, MSEDATC

Practitioner Athletic Trainer Rockford, IL

Practice location

Address: 5510 E State St, Rockford, IL 61108-2381
Phone: (815) 395-4505
Fax: (815) 395-4507
Mailing address: 165 Harvest Glenn Dr, Davis Junction, IL 61020-9797

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Illinois →

Registry record

NPI: 1134198211
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Mar 2006
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.