Theresa Talia Smith

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

060991056 Issued in IL

Practice address

122 Baker Rd
Lake Bluff, IL 60044-1424

Phone

(630) 486-7068

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1518778117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BAKER RD",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441424",
            "telephone_number": "630-486-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 BAKER RD",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441424",
            "telephone_number": "630-486-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THERESA",
        "middle_name": "TALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IL",
            "license": "060991056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Rose Shulman
• Howard Wayne Siegel
• Michelle R Singapori
• Thomas Joseph Singel II, DO
• Dana Alaine Slowinski, LCSW
• John C Somberg, MD
• Robert H Sorensen, M.D.
• Emily J Soriaga
• Dana Spehlmann
• Rachael Denise Spencer, RN

• Basic Emergency Medical Technician in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Basic Emergency Medical Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.