Kyran D Smith, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

201548747 Issued in IL

Practice address

901 Maple Ave
Evanston, IL 60202-1717

Phone

(224) 478-5858

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• VA Chicago

  • Multi-Specialty Clinic/Center
  • Evanston, IL
  • NPI 1730896747
  NPD Authorized official

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1659088664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MAPLE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021717",
            "telephone_number": "708-522-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MAPLE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021717",
            "telephone_number": "224-478-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYRAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "201548747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kyransmith123456@gmail.com",
            "affiliation": "N",
            "address_1": "901 Maple Ave",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602021717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Becky Alison Smith, MD
• Crystal Lauren Smith, BC-DMT, LCPC
• Gail Susan Smith, MD
• India Smith, LCSW
• Kimberly Mays Smith, DDS
• Laura Anne Smith
• Lauren Smith
• Lauren A. Smith
• M. Summer Smith
• Marsha A Smith, LCSW

• Adult Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Adult Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.