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NPI 1255314357

NPI 1255314357 : JAMES A. DALEO MD : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1255314357
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES A. DALEO MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/22/2005
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    Last Update Date     |    08/23/2010
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Provider Practice Location Address
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    Address Line         |    7107 W BELMONT AVE SUITE 7
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60634-4688
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    Country              |    US
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    Telephone            |    773-622-2006
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7634 W BELMONT AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60634-3110
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    Country              |    US
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    Telephone            |    773-589-1677
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    Fax                  |    773-589-1688
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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       |    036064448
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    License Number State |    IL
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