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General NPI Number Information
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NPI Number | 1174707004
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Entity Type | Individual
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Provider Name | SCOTT L CHANEY PAC
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Gender | Male
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 355 RIDGE AVE SAINT FRANCIS HOSPITAL PHYSICIAN ASSISTANCE
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City | EVANSTON
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State | IL
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Zip | 60202-3328
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Country | US
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Telephone | 847-316-6370
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Fax |
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Provider Business Mailing Address
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Address Line | 947 HARRIS RD
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City | GRAYSLAKE
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State | IL
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Zip | 60030-3549
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Country | US
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Telephone | 847-316-3149
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Fax | 847-316-2928
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | IL
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