Jeremy Smith is a Sports in Lake Forest, Illinois. Jeremy Smith practices all healthcare services and medical treatments related to Sports. The NPI Number for Jeremy Smith is 1184830812. The last update date is 2013-08-18.
Jeremy Smith's current location address is 1920 Football Dr, Lake Forest, Illinois. You can contact this provider via phone number 8477395405. The mailing address for Jeremy Smith is 1920 Football Dr, Lake Forest, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremy Smith |
|---|---|
| Address | 1920 Football Dr, Lake Forest, Illinois |
| Phone Number | 8477395405 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1184830812 |
|---|---|
| Provider Enumeration Date | 2007-05-16 |
| Last Updated Date | 2013-08-18 |
Provider Mailing Address Detail
| Address | 1920 Football Dr |
|---|---|
| City | Lake Forest |
| State | Illinois (IL) |
| Post Code | 600454829 |
| Phone Number | 8477395405 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports |
|---|---|
| Taxonomy | 2251S0007X |
| Licence No | 70.016666 |
|
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 70.016666 | IL | ILLINOIS STATE LICENSE | |
| 70.016666 | IL | IL LICENSE PT | |
| 96.002695 | IL | ILLINOIS STATE LICENSE | |
| 96.002695 | IL | IL LICENSE ATC |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jeremy Smith by the Centers for Medicare & Medicaid Services?
The Jeremy Smith has been issued the NPI (National Provider Identifier) 1184830812 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Jeremy Smith?
The Jeremy Smith is physically situated at 1920 Football Dr, in the city of Lake Forest, state of IL, with the postal code 600454829.
What is Jeremy Smith's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jeremy Smith is Sports, and the taxonomy classification code that categorizes this area of expertise is 2251S0007X.
On what date did the Centers for Medicare & Medicaid Services assign the 1184830812 to Jeremy Smith?
The Centers for Medicare & Medicaid Services assigned the 1184830812 to Jeremy Smith on 2007-05-16.
As of what date were the details related to Jeremy Smith most recently updated or revised?
The information pertaining to Jeremy Smith, including its address, specialty, and other relevant details, was last updated or revised on 2013-08-18.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC