Search › Illinois › 104100000X
Jeremy Smith, LSW
NPI 1174094197 · on the registry since 2018 · sole proprietor
Practice
- Address
- 2101 Fox Drive Suite 102
Champaign, IL 61820 - Phone
- (217) 766-0258
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 171M00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-12-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois