Michelle Dawn Smith, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

041.319868 Issued in IL

Practice address

410 1St St
Kirkland, IL 60146-7700

Phone

(815) 522-2659

Fax

(815) 522-3185

NPI assigned

Feb 10, 2021

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1669064796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 1ST ST",
            "city": "KIRKLAND",
            "state": "IL",
            "postal_code": "601467700",
            "telephone_number": "815-522-2659",
            "fax_number": "815-522-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 1ST ST",
            "city": "KIRKLAND",
            "state": "IL",
            "postal_code": "601467700",
            "telephone_number": "815-522-2659",
            "fax_number": "815-522-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "IL",
            "license": "041.319868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Madsen, DMD
• Thomas L. Michalsen, D.O.
• Michelle Platt, PH.D.
• Barbara J Runne, DDS
• Simple RX Inc.
• Thomas L. Michalsen DO LTD
• White Oak Dental LLC
• Kristine Wirtz, RBT-18-54764

• All providers in Kirkland, IL
• School Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.