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General NPI Number Information
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NPI Number | 1215422084
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Entity Type | Individual
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Provider Name | EVIN ARYAN KOLEINI
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Gender | Male
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 701 W NORTH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160-1612
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Country | US
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Telephone | 708-538-4934
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Fax | 708-538-5328
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Provider Business Mailing Address
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Address Line | 5021 ROCKLEDGE DR
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City | CLARENCE
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State | NY
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Zip | 14031-2426
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Country | US
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Telephone | 716-440-1584
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036159914
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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