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General NPI Number Information
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NPI Number | 1174505325
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Entity Type | Individual
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Provider Name | MICHELE M MITCHELL MD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1923 W GLEN PARK AVE
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City | GRIFFITH
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State | IN
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Zip | 46319-3703
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Country | US
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Telephone | 219-922-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W WACKER DR
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City | CHICAGO
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State | IL
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Zip | 60601-1606
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Country | US
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Telephone | 571-721-8689
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.159710
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME88708
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License Number State | FL
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