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General NPI Number Information
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NPI Number | 1053210450
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Entity Type | Individual
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Provider Name | MADISON PAIGE WADE
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2529
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Country | US
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Telephone | 217-383-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 501 E SOUTH MAHOMET RD
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City | MAHOMET
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State | IL
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Zip | 61853-3612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.026978
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License Number State | IL
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