Bruce Sylvester Smith MD LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BRUCE SYLVESTER SMITH MD LLC

Practice address

104 W 6TH St
Suite 206
Streator, IL 61364-2899

Phone

(815) 672-1610

Fax

(815) 672-1615

NPI assigned

Mar 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Sylvester Smith, MD

Title

Owner

Phone

(815) 672-1610

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1568634806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "address_2": "SUITE 206",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-672-1610",
            "fax_number": "815-672-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "address_2": "SUITE 206",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-672-1610",
            "fax_number": "815-672-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE SYLVESTER SMITH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "SYLVESTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-672-1610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Streator, IL
• Providers in Streator, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.