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General NPI Number Information
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NPI Number | 1184859183
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Entity Type | Organization
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Legal Business Name | ULTIMATE CARE ONCOLOGY
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 5611 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5302
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Country | US
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Telephone | 773-770-6400
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Fax | 773-385-5375
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Provider Business Mailing Address
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Address Line | 5611 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5302
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Country | US
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Telephone | 773-770-6400
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Fax | 773-385-5375
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Authorized Official
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Title or Position | ONCOLOGY & HEMATOLOGY
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Name | MR. AHMAD JAJEH
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Credential | M.D.
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Telephone | 773-770-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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