Provider Demographics
NPI:1669841508
Name:SMITH, HILDA G (PMNNP-BC, MSN, MPH)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:G
Last Name:SMITH
Suffix:
Gender:
Credentials:PMNNP-BC, MSN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746721
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6721
Mailing Address - Country:US
Mailing Address - Phone:773-352-1515
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:4848 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2718
Practice Address - Country:US
Practice Address - Phone:773-724-6200
Practice Address - Fax:773-866-8015
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021519363LP0808X
MO125459163WP0808X
MO2015032902163WP0808X
NMCNP-03139363LP0808X
MO2015012933363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health