MR. MARC GERALD SMITH (NPI# 1497045579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497045579 |
| Entity Type | Individual |
| Full Name | MR. MARC GERALD SMITH |
| Credential | IDC |
| Practice Address |
3355 Illinois St Bldg 1007 Great Lakes IL 60088-3115 |
| Mailing Address |
3355 Illinois St Bldg 1405 Great Lakes IL 60088-3115 |
| Practice Telephone | 8476884346 |
| Practice Fax Number | 8476883690 |
| Mailing Telephone | 8476884346 |
| Mailing Fax Number | 8476883690 |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497158380 | Marc Smith | Social Worker | 39640 Hillary Dr, Canton, MI 48187-4208 | 2014-10-06 |
| 1871122960 | Marc E. Smith | Case Manager/Care Coordinator | 10296 Springfield Pike Ste 500, Cincinnati, OH 45215-1194 | 2020-04-02 |
| 1588208276 | Marc Smith | Case Manager/Care Coordinator | 3316 Laverne Ave, Bakersfield, CA 93309-4122 | 2019-11-05 |
| 1144788993 | Marc Smith | Speech-Language Pathologist | 400 Dawson Rd., Forrest City, AR 72335 | 2019-03-11 |
| 1942706841 | Marc Charles Smith | Student in an Organized Health Care Education/Training Program | 1200 N. State Street, Ct-a7d, Los Angeles, CA 90033 | 2018-04-01 |
| 1154847713 | Marc C Smith | Nurse Anesthetist, Certified Registered | 2001 W 68th St, Hialeah, FL 33016-1801 | 2017-08-16 |
| 1992981138 | Marc Newell Smith | Social Worker | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2008-01-17 |
| 1396969580 | Marc I Smith | Physical Therapist | 315 S Manning Blvd, Albany, NY 12208-1707 | 2007-04-12 |
| 1730256785 | Marc Richard Smith | Nurse Anesthetist, Certified Registered | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-11-28 |
| 1427133446 | Marc Lloyd Smith | General Practice | 11803 W North Ave, Wauwatosa, WI 53226 | 2006-10-26 |
| Street Address |
3355 ILLINOIS ST BLDG 1007 |
| City | GREAT LAKES |
| State | IL |
| Zip Code | 60088-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858228 | Kathryn Ann Bird | Dentist | 3440 W Ohio St, Uss Osborne Branch Dental Clinic, Great Lakes, IL 60088 | 2019-12-18 |
| 1740775576 | Jonathan William Criter | Dentist | 3400 Ohio St, Great Lakes, IL 60088 | 2018-06-25 |
| 1134598733 | True Xiong | Dentist | Zachary & Elizabeth Fisher Medical & Dental Clinic, 2470 Sampson Street, Apo, AA 60088 | 2015-09-24 |
| 1447685771 | Lisa Carol Perrone | Dentist | Fhcc Lovell Bldg 237 Dental, Navsta Great Lakes, North Chicago, IL 60088 | 2013-09-05 |
| 1437438421 | David Lawrence Green | Dentist | 2410 Samson St., Bldg 237, Great Lakes, IL 60088 | 2011-08-09 |
| 1164730602 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois Street, Great Lakes, IL 60088 | 2010-09-17 |
| 1598073439 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois St, Bldg 1007, Great Lakes, IL 60088 | 2010-09-14 |
| 1083943906 | James Doll | Dentist | 2608 Paul Jones St, Great Lakes, IL 60088 | 2009-12-24 |
| 1396996823 | Kelly Robert Lanning | Dentist | 3001 A 6th St Bhc 237, Naval Hospital Great Lakes- Dental Dept., Great Lakes, IL 60088 | 2008-10-02 |
| 1841453750 | Peter Jerome Hammes | Dentist | 3001a Sixth Street Bldg 200h 4e, Naval Health Clinic Great Lakes, Great Lakes, IL 60088 | 2008-07-10 |
| Find all providers in zip 60088 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215333299 | Jonathan Ramonbeebe | Military Health Care Provider | 3694 Minnesota Ave Apt D, Great Lakes, IL 60088-1714 | 2014-11-18 |
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| 1497917876 | Scott David Arnold | Military Health Care Provider | 320 Dewey Ave Ste A, Naval Special Warfare Preparatory School Bldg 322, Great Lakes, IL 60088-2911 | 2008-06-27 |
| 1184883688 | Michael Paul Coffman | Military Health Care Provider | 601 D Street, Great Lakes, IL 60088-2822 | 2008-06-09 |
| 1184809048 | Rodolfo Pineda Manansala | Military Health Care Provider | 601 D St Bldg 130-h, Great Lakes, IL 60088-2822 | 2008-01-09 |
| 1346454808 | Joseph Thomas Minich | Military Health Care Provider | 2410 Sampson St Bldg 237, Great Lakes, IL 60088-2942 | 2007-05-10 |
| 1679786057 | James R Butts | Military Health Care Provider | 329 Dewy Ave, Great Lakes, IL 60088 | 2007-05-08 |
| 1205891256 | Jose Alfredo Nicola | Military Health Care Provider | Naval Health Clininc Great Lakes, Branch Medical Clinic 1007 Uss Tranquility, Great Lakes, IL 60088 | 2006-04-20 |
| 1205804242 | Rodger M Howard | Military Health Care Provider | 3420 Illinois Street Bldg 1007, Great Lakes, IL 60088 | 2006-03-08 |
| 1144588039 | Luis Victor Fernandez | Military Health Care Provider | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2012-04-27 |
| Find all providers in GREAT LAKES | ||||
| City | GREAT LAKES |
| Zip Code | 60088 |
Please comment or provide details below to improve the information on MR. MARC GERALD SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.