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General NPI Number Information
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NPI Number | 1124079249
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Entity Type | Individual
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Provider Name | JOHN D EDWARDS MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 880 W CENTRAL RD SUITE 5000
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2355
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Country | US
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Telephone | 847-618-3800
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Fax | 847-618-3809
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Provider Business Mailing Address
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Address Line | 880 W CENTRAL RD STE 5000
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2355
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Country | US
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Telephone | 847-618-3800
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Fax | 847-618-3809
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101249785
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35-072723
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 38823
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036139185
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License Number State | IL
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