Provider Demographics
NPI:1720132780
Name:SMEIR, ISSAM Y (MA)
Entity Type:Individual
Prefix:MR
First Name:ISSAM
Middle Name:Y
Last Name:SMEIR
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2S156 BIG HORN DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-7829
Mailing Address - Country:US
Mailing Address - Phone:630-462-7566
Mailing Address - Fax:630-462-8103
Practice Address - Street 1:2S156 BIG HORN DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-7829
Practice Address - Country:US
Practice Address - Phone:630-462-7566
Practice Address - Fax:630-462-8103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional