Whalio Doctors

NPI 1154671394

Justin Darren Smith, CSFA

Practitioner Surgical Assistant Zion, IL

Practice location

Address
2520 Elisha Avenue, Zion, IL 60099
Phone
(847) 561-7460
Mailing address
11854 214th Avenue, Bristol, WI 53104

Registered specialties (2)

Surgical Assistant Primary
Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X
Contractor
Other Service Providers Taxonomy 171W00000X Licence 238.000298 (IL)

Registry record

NPI
1154671394
Entity type
Individual
Sex (as registered)
Male
NPI issued
14 Sep 2012
Record last updated
27 Mar 2023

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.