Provider Demographics
NPI:1609190693
Name:SMIELEWSKI, ERIN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:SMIELEWSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:351 GREENLEAF ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:PARK CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5701
Mailing Address - Country:US
Mailing Address - Phone:847-263-6073
Mailing Address - Fax:847-244-7323
Practice Address - Street 1:351 GREENLEAF ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PARK CITY
Practice Address - State:IL
Practice Address - Zip Code:60085-5701
Practice Address - Country:US
Practice Address - Phone:847-263-6073
Practice Address - Fax:847-244-7323
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005398213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist