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General NPI Number Information
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NPI Number | 1154292662
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Entity Type | Organization
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Legal Business Name | NEUROMED HEALTHCARE PLLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 4300 N BRANDYWINE DR
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City | PEORIA
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State | IL
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Zip | 61614-5550
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Country | US
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Telephone | 309-338-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 118 N BROADWAY ST
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City | LEWISTOWN
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State | IL
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Zip | 61542-1202
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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 | OWNER/MANAGER
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Name | DR. BENJAMIN JOSEPH MILES
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Credential | DC
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Telephone | 309-338-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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