ES
EARNEST SMITH
SE217861 · 03/02/1953 · Updated 04/10/2026
Active
Basic Information
| Patient Record Number: | SE217861 |
| Date of Birth: | 03/02/1953 |
| Age: | 73 |
| Sex: | male |
| SSN: | N/A |
| Medicare Number: | N/A |
| Last Updated: | 04/10/2026 05:29 PM |
Contact Information
| Mobile Phone: | (708) 502-0579 |
| Home Phone: | N/A |
| Email: | N/A |
| Emergency Contact: | N/A |
| Emergency Phone: | N/A |
| Last Seen: | Never |
| Provider: | Kalpana Mutyala |
Address Information
4715 SAINT CHARLES RD
Bellwood, IL 60104 Coordinates: 41.8891749, -87.8915426
Bellwood, IL 60104 Coordinates: 41.8891749, -87.8915426
Home Health Nurse
MEDIC HOME HEALTHCARE
| Phone: | 888-207-6251 |
| Fax: | 888-207-6250 |
| Status: | Active |
Medicare Part B Deductible
No deductible information available
Annual Wellness Visit
No wellness visit information available
Discharge History
View AllNo discharge history
Patient Actions
Appointment History
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Patient Documents
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Total Claims-
Total Paid-
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Payment RateRemittance Claims
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