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General NPI Number Information
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NPI Number | 1144304874
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Entity Type | Individual
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Provider Name | CAROL BALLOU M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/28/2015
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Provider Practice Location Address
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Address Line | 501 W OGDEN AVE STE 6
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City | HINSDALE
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State | IL
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Zip | 60521-3184
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Country | US
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Telephone | 630-321-9590
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Fax | 630-920-0931
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Provider Business Mailing Address
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Address Line | PO BOX 261
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City | WESTERN SPRINGS
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State | IL
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Zip | 60558-0261
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Country | US
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Telephone | 630-321-9590
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Fax | 630-986-1477
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-058329
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License Number State | IL
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