Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 036-110905 | IL |
NPI | 1013943729 |
---|---|
Provider Name | Laisvyde Smajkic |
First Address | Chicago, IL 60674-0001 |
Second Address | Westmont, IL 60559-1162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 16/04/2012 |