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General NPI Number Information
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NPI Number | 1023465655
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Entity Type | Organization
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Legal Business Name | KATHRYN SKOLARZ, M.D., S.C.
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE SUITE 366
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 773-594-1410
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Fax | 773-774-1402
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE SUITE 366
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 773-594-1410
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Fax | 773-774-1402
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Authorized Official
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Title or Position | PHYSICIAN
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Name | KATHRYN SKOL
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Credential | M.D.
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Telephone | 312-505-6577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036136435
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License Number State | IL
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