Clasina Leslie Smith, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036.124367 Issued in IL

Practice address

4753 N Broadway St
Suite 910
Chicago, IL 60640-5266

Phone

(773) 609-3520

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• C Leslie Smith MD Inc

  • General Practice Physician
  • Chicago, IL
  • NPI 1376975094
  NPD (past) Authorized official

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1437342433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 N WINTHROP AVE",
            "address_2": "APT 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402389",
            "telephone_number": "773-350-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST",
            "address_2": "SUITE 910",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405266",
            "telephone_number": "773-609-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLASINA",
        "middle_name": "LESLIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A118378",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.124367",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.124367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clasinasmith@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "4753 N Broadway St",
            "address_2": "Suite 910",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Anne Smith, APN
• Christopher Andrew Smith, M.D.
• Christopher Jon Smith
• Claire Emma Smith
• Clarissa Beth Smith, MD
• Clifford A. Smith, PHD
• Collette Smith, COTA/L
• Conner Smith, RN
• Coran Smith
• Corinne Reidy Smith, RDN

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.