Provider Demographics
NPI:1427444785
Name:DR SJ SMITHERMAN TOTAL HEALTH SOLUTIONS, SC
Entity type:Organization
Organization Name:DR SJ SMITHERMAN TOTAL HEALTH SOLUTIONS, SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:SMITHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:872-222-5776
Mailing Address - Street 1:200 E ROOSEVELT RD
Mailing Address - Street 2:BUCHHOLZ 202
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4539
Mailing Address - Country:US
Mailing Address - Phone:872-222-5776
Mailing Address - Fax:206-278-8225
Practice Address - Street 1:200 E ROOSEVELT RD
Practice Address - Street 2:BUCHHOLZ 202
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4539
Practice Address - Country:US
Practice Address - Phone:872-222-5776
Practice Address - Fax:206-278-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012763111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty