KEVIN M SMITH (NPI# 1710096557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710096557 |
| Entity Type | Individual |
| Full Name | KEVIN M SMITH |
| Credential | MD |
| Practice Address |
1333 Burr Ridge Pkwy Ste 200 Burr Ridge IL 60527-0833 |
| Practice Telephone | 6307565270 |
| Practice Fax Number | 5745384859 |
| Mailing Telephone | 6307565270 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036-093367 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036093367 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Gore Rd, Ste. H, Morris, IL 604509466 | 8153648919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790394310 | Kevin Lee Smith | Technician | 97 Culp Dr, Ridgeley, WV 26753-7407 | 2020-07-29 |
| 1295397495 | Kevin James Smith | Social Worker | 1076 E Rubicon Dr, Boise, ID 83716-5279 | 2019-07-08 |
| 1649831546 | Kevin Smith | Dentist | 5657 S Himalaya St Ste 270, Aurora, CO 80015-5310 | 2019-06-22 |
| 1992362875 | Kevin Gene Smith | Social Worker | 1293 Page Rd, Raleigh, NC 27603-7334 | 2019-05-25 |
| 1700314952 | Kevin Matthew Smith | Pediatrics | 715 Camino Catalina, Solana Beach, CA 92075-1631 | 2017-06-01 |
| 1124565759 | Kevin Smith | Driver | 530 Yates Ave, Calumet City, IL 60409-3119 | 2017-01-20 |
| 1487005047 | Kevin Smith | Massage Therapist | 19615 Se 342nd St, Auburn, WA 98092-1500 | 2016-06-24 |
| 1679929806 | Kevin Smith | Durable Medical Equipment & Medical Supplies | 76 Birchmount Cir, West Henrietta, NY 14586-9452 | 2016-05-06 |
| 1871998716 | Kevin Michael Smith | Physical Therapist | 15 Corporate Plaza Dr Ste 130, Newport Beach, CA 92660-7940 | 2014-11-04 |
| 1144646993 | Kevin Smith | Occupational Therapist | 322 Pillings Pond Rd, Lynnfield, MA 01940-1345 | 2014-03-17 |
| Street Address |
1333 BURR RIDGE PKWY STE 200 |
| City | BURR RIDGE |
| State | IL |
| Zip Code | 60527-0833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851361885 | Candice Sue Anderson | Family Medicine | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527 | 2006-01-24 |
| 1720609944 | Alison Spillers | Counselor | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2020-04-28 |
| 1629605712 | Venvisor Health Illinois LLC | Nurse Practitioner | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2020-03-26 |
| 1902367758 | Saba Montazerian | Marriage & Family Therapist | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2019-03-26 |
| 1992299788 | Walsh Nutrition Group, Inc. | Dietitian, Registered | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-06-15 |
| 1639663412 | Laura Walsh | Dietitian, Registered | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-06-15 |
| 1073007837 | Sarah A Matlin | Counselor | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527 | 2018-06-15 |
| 1386134898 | Veteran Innovation LLC | Psychologist | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-05-10 |
| 1699277277 | Brookside Clinical Services | Community/Behavioral Health | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2018-02-28 |
| 1205280674 | Magdalena Daoud | Nurse Practitioner | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527-0833 | 2016-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023635364 | Crystal Mary Dirks | Occupational Therapy Assistant | 211 75th St, Burr Ridge, IL 60527 | 2020-07-02 |
| 1386276350 | Valerie Moreno-tucker | Counselor | 277 83rd St, Burr Ridge, Il 60527, Burr Ridge, IL 60527 | 2020-02-07 |
| 1831734763 | Annette Maria Zajac | Occupational Therapist | 16 91st St., Burr Ridge, IL 60527 | 2019-11-14 |
| 1568023109 | Jennifer Rogers | Counselor | 277 83rd St., Ste. D, Burr Ridge, IL 60527 | 2019-06-25 |
| 1710458526 | Dima Sibai Dds PC | Clinic/Center | 940 Plianfield Rd., Willowbrook, IL 60527 | 2018-12-06 |
| 1558850495 | Jeanie C. Lucy PC | Optometrist | 6340 Americana Drive Suite 1108, Willowbrook, IL 60527 | 2018-05-07 |
| 1538664032 | Athletico,ltd | Physical Therapist | 6860 N Frontage Rd Ste B, Burr Ridge, IL 60527 | 2018-03-27 |
| 1003314832 | Ams Wellness Pllc | Psychologist | 277 83rd St Ste D, Burr Ridge, IL 60527 | 2018-01-26 |
| 1023564671 | Natasa Manasovska | Dentist | 6111 Knollwood Rd, Apt. 103, Willowbrook, IL 60527 | 2016-09-01 |
| 1669927893 | Marie Ann Korallus | Nurse Practitioner | 7055 High Grove, Burr Ridge, IL 60527 | 2016-08-17 |
| Find all providers in zip 60527 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063800142 | Farouk B Asaad | Family Medicine | 705 Ambriance Dr, Burr Ridge, IL 60527-0807 | 2014-12-24 |
| 1467721506 | Leo Joseph Knaff | Family Medicine | 605 Burr Ridge Club Dr, Burr Ridge, IL 60527-5272 | 2011-12-19 |
| 1760617286 | Shua Medical Group, Inc. | Family Medicine | 322 Burr Ridge Pkwy, Burr Ridge, IL 60527-6485 | 2009-05-28 |
| 1558502872 | Julie Marlane Rubin | Family Medicine | 6768 Fieldstone Dr, Burr Ridge, IL 60527-5298 | 2009-03-17 |
| 1689810129 | Roy P Thomas | Family Medicine | 8516 Wedgewood Dr, Burr Ridge, IL 60527-6353 | 2009-01-06 |
| 1043473747 | Ahmed Shafi P C | Family Medicine | 9101 Devon Ridge Dr, Burr Ridge, IL 60527-8368 | 2008-07-03 |
| 1154476299 | Patricia Higgins | Family Medicine | 6800 N Frontage Rd, Burr Ridge, IL 60527-7819 | 2007-01-25 |
| 1831100569 | Saleha Khan | Family Medicine | 9465 Est Fallingwater Drive, Burr Ridge, IL 60521 | 2006-08-10 |
| 1851361885 | Candice Sue Anderson | Family Medicine | 1333 Burr Ridge Pkwy Ste 200, Burr Ridge, IL 60527 | 2006-01-24 |
| 1194155291 | Adventist Health Partners, Inc | Family Medicine | 901 Mcclintock Dr, Suite 110, Burr Ridge, IL 60527-0871 | 2013-11-26 |
| Find all providers in BURR RIDGE | ||||
| City | BURR RIDGE |
| Zip Code | 60527 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.