KELLY ELIZABETH SMYTH (NPI# 1730634791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730634791 |
| Entity Type | Individual |
| Full Name | KELLY ELIZABETH SMYTH |
| Credential | PA-C |
| Practice Address |
680 N Lake Shore Dr Chicago IL 60611 |
| Mailing Address |
184 Griswold Dr West Hartford CT 06119-1021 |
| Practice Telephone | 3126950665 |
| Practice Fax Number | 3126956594 |
| Mailing Telephone | 8608780869 |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2018-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085.006397 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3654 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL PA LICENSE | 085.006397 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 41 Brewster Rd, Bristol, CT 060105161 | 8605853000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477078608 | Kelly Harrington Smyth | Psychologist | 555 Cincinnati Batavia Pike, Cincinnati, OH 45244-1557 | 2017-08-09 |
| Street Address |
680 N LAKE SHORE DR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427052885 | Jeanette A. Dubay-mcdermit | Nurse Anesthetist, Certified Registered | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2005-06-13 |
| 1023621406 | Akshar Patel | Student in an Organized Health Care Education/Training Program | 680 N Lake Shore Dr, Tower Apt 720, Chicago, IL 60611 | 2020-08-26 |
| 1952873267 | Kimberly Sumislawski | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-12-27 |
| 1598251571 | Asia Giammarco | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-07-02 |
| 1497253256 | Samantha M C Tan | Nurse Practitioner | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-01-26 |
| 1871040642 | Kathleen Dady | Genetic Counselor, MS | 680 N Lake Shore Dr, Suite 1230, Chicago, IL 60611-4546 | 2016-09-08 |
| 1205382496 | Rachel Green Dunn | Nurse Practitioner | 680 N Lake Shore Dr, Suite 117, Chicago, IL 60611-4546 | 2016-08-29 |
| 1982158036 | Patricia Gale, Md, S.c. | Clinic/Center | 680 N Lake Shore Dr, Suite 930, Chicago, IL 60611-4546 | 2016-08-06 |
| 1013460930 | Julia Goldin | Registered Nurse | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2016-07-27 |
| 1417400219 | Lisa Ha | Nurse Practitioner | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2016-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1407331184 | David Reyes | Physician Assistant | 2800 N Sheridan Rd Ste 209, Chicago, IL 60657-6157 | 2018-09-28 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1811494917 | Nicole Fisch | Physician Assistant | 7447 W Talcott Ave Ste 512, Chicago, IL 60631-3716 | 2018-04-06 |
| 1477909448 | Temidayo Olugbenga Odugbesan | Physician Assistant | 7016 S Sangamon St, Apt 3s, Chicago, IL 60621-1759 | 2016-05-10 |
| 1689096257 | Natalie Elizabeth Warmuth | Physician Assistant | 830 West Diversey Pkwy., Suite 300, Chicago, IL 60614-8711 | 2014-01-15 |
| 1184062754 | Lindsay Christine Jones | Physician Assistant | 205 East Huron, Northwestern Memorial Hospital Galter 11-140, Chicago, IL 60611 | 2013-06-05 |
| 1366741449 | Monica L Fiehler | Physician Assistant | 3537 Paysphere Cir, Chicago, IL 60674-0001 | 2011-03-15 |
| Find all providers in CHICAGO | ||||
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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.