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General NPI Number Information
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NPI Number | 1144327602
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Entity Type | Individual
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Provider Name | BASIL S HERNANDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 3815 HIGHLAND AVE STE G130A
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1500
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Country | US
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Telephone | 312-609-0300
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Fax | 630-275-6075
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1285
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-116747
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036-116747
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License Number State | IL
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