Provider Demographics
NPI:1346824620
Name:AZIZ SMITH, RAHMANA (AGACNP-BC, NP)
Entity Type:Individual
Prefix:
First Name:RAHMANA
Middle Name:
Last Name:AZIZ SMITH
Suffix:
Gender:F
Credentials:AGACNP-BC, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 S MANISTEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-4126
Mailing Address - Country:US
Mailing Address - Phone:773-480-7110
Mailing Address - Fax:
Practice Address - Street 1:1645 S RIVER ROAD INC
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60019-1443
Practice Address - Country:US
Practice Address - Phone:224-803-2273
Practice Address - Fax:224-803-2274
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.360691163WC0200X
IL041360691163WP2201X
IL209023475207P00000X, 207PE0004X, 207QG0300X, 207RA0002X, 207RE0101X, 207RG0300X, 207RI0011X, 207RP1001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart Disease
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease