NPI 1710191564
Jack Smith, L.C.P.C.
Counselor, Professional · Orland Park, IL
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 15, 2026, 12:27 am EDT
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Jack Smith, L.C.P.C. is a health care provider (Counselor, Professional) in Orland Park, Illinois with National Provider Identifier (NPI) 1710191564. The NPI was issued on May 10, 2007 and the registry record was last updated on Jul 8, 2007. The registry lists a license in Illinois.
Registry record
- NPI
- 1710191564
- Type
- Individual (NPI-1), sole proprietor
- Primary specialty
- Counselor, Professional 101YP2500X
- Practice location
- 15040 S Ravinia Ave Ste 44
Orland Park, IL 60462-3173 - Phone
- (708) 226-1280
- NPI issued
- May 10, 2007
- Registry record updated
- Jul 8, 2007
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | Illinois | 180005924 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Professional Counselor providers in Illinois
- Gabrielle Anne Johnson, LCPCCrystal Lake, IL
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.