Provider Demographics
NPI:1194284570
Name:WILSON AND SMITH INC.
Entity type:Organization
Organization Name:WILSON AND SMITH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:773-445-9111
Mailing Address - Street 1:10450 S VINCENNES AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2957
Mailing Address - Country:US
Mailing Address - Phone:773-445-9111
Mailing Address - Fax:773-445-9150
Practice Address - Street 1:10450 S VINCENNES AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2957
Practice Address - Country:US
Practice Address - Phone:773-445-9111
Practice Address - Fax:773-445-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies