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General NPI Number Information
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NPI Number | 1083756050
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Entity Type | Individual
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Provider Name | MONICA ANN MOZWECZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 5600 WOLF RD SUITE 110
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City | WESTERN SPRINGS
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State | IL
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Zip | 60558-2254
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Country | US
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Telephone | 708-246-4155
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Fax | 708-246-9489
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Provider Business Mailing Address
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Address Line | 1860 PAYSPHERE CIR
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City | CHICAGO
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State | IL
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Zip | 60674-0018
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Country | US
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Telephone | 708-246-4155
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Fax | 708-246-9489
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036072941
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License Number State | IL
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