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General NPI Number Information
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NPI Number | 1033213038
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE ONCOLOGY INSTITUTE LIMITED
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 567 N WESTGATE AVE
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City | JACKSONVILLE
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State | IL
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Zip | 62650-1156
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Country | US
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Telephone | 217-243-8400
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Fax | 217-245-8700
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Provider Business Mailing Address
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Address Line | 567 N WESTGATE AVE PO BOX 797
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City | JACKSONVILLE
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State | IL
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Zip | 62650-1156
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Country | US
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Telephone | 217-243-8400
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Fax | 217-245-8700
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Authorized Official
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Title or Position | PRESIDENT
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Name | SALEEM MAHMOOD
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Credential | MD
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Telephone | 217-243-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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