Provider Demographics
NPI:1700860707
Name:SMITH, ERICA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 NORTH MILWAUKEE AVENUE
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061
Mailing Address - Country:US
Mailing Address - Phone:847-941-7614
Mailing Address - Fax:847-941-7697
Practice Address - Street 1:225 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4304
Practice Address - Country:US
Practice Address - Phone:847-941-7614
Practice Address - Fax:847-941-7697
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2021-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301074536207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H72280Medicare UPIN