Provider Demographics
NPI:1174282610
Name:SMC MEDICAL PROFESSIONALS LTD
Entity Type:Organization
Organization Name:SMC MEDICAL PROFESSIONALS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CIOTOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-260-1818
Mailing Address - Street 1:800 ROOSEVELT RD
Mailing Address - Street 2:BLDG B, SUITE 114
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137
Mailing Address - Country:US
Mailing Address - Phone:636-474-2626
Mailing Address - Fax:630-474-2629
Practice Address - Street 1:800 ROOSEVELT RD STE 114
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5839
Practice Address - Country:US
Practice Address - Phone:630-474-2626
Practice Address - Fax:630-474-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty