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General NPI Number Information
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NPI Number | 1205027810
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Entity Type | Organization
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Legal Business Name | A M JABR MD SC
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 260
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City | CHICAGO
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State | IL
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Zip | 60622-2990
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Country | US
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Telephone | 773-227-3770
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Fax | 773-227-9737
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Provider Business Mailing Address
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Address Line | PO BOX 724
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City | ORLAND PARK
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State | IL
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Zip | 60462-0724
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Country | US
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Telephone | 708-364-7666
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Fax | 866-596-1007
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Authorized Official
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Title or Position | OWNER
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Name | DR. AYMAN JABR
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Credential | MD SC
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Telephone | 773-227-3770
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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 | 036110045
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License Number State | IL
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