Provider Demographics
NPI:1356709489
Name:SMARTCAREHUB LLC
Entity type:Organization
Organization Name:SMARTCAREHUB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-684-2303
Mailing Address - Street 1:1415 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2074
Mailing Address - Country:US
Mailing Address - Phone:312-806-3800
Mailing Address - Fax:630-684-2299
Practice Address - Street 1:1415 W 22ND ST
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2074
Practice Address - Country:US
Practice Address - Phone:312-806-3800
Practice Address - Fax:630-684-2299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMARTCAREHUB INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty