Cornelius K Smith, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036-057706 Issued in IL

Practice address

1221 N Highland Ave
Aurora, IL 60506-1404

Phone

(630) 859-8700

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1194741298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064356",
            "telephone_number": "630-859-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061404",
            "telephone_number": "630-859-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CORNELIUS",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036-057706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE #",
            "identifier": "P00921",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057706",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Smith, PMHNP-BC
• Allison Patricia Smith
• Anissa M Smith
• Bradley Smith
• Carolyn E. Smith, CRNA
• Daniel Smith
• Demetrea Smith
• Jayla Smith
• Jennifer Smith, BA MHP
• Jill Headley Smith, SLP-A

• Urology Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.