Individual provider Active NPI

Laura Lee Smith, M.S.O.M., L.AC., B.S

  • Acupuncturist
  • Gurnee, IL
National Provider Identifier
1700015344
Registry record updated Jul 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198.000833 Issued in IL
Practice address
34991 N Cemetery Rd
Gurnee, IL 60031-2465
Phone
(847) 244-9473
NPI assigned
Jul 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198.000833 IL Primary

Addresses

Primary practice location

34991 N Cemetery Rd
Gurnee, IL 60031-2465

Mailing address

34991 N Cemetery Rd
Gurnee, IL 60031-2465
Phone (847) 244-9473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
198.000833ILMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246579200000",
    "number": "1700015344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34991 N CEMETERY RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312465",
            "telephone_number": "847-244-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34991 N CEMETERY RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312465",
            "telephone_number": "847-244-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "credential": "M.S.O.M., L.AC., B.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-03",
        "last_updated": "2009-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.000833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; 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.