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General NPI Number Information
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NPI Number | 1275756769
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Entity Type | Organization
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Legal Business Name | S HARSOOR MD SC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/12/2009
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Provider Practice Location Address
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Address Line | 2315 E 93RD ST SUITE #: 237
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City | CHICAGO
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State | IL
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Zip | 60617-3936
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Country | US
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Telephone | 630-229-5701
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3307
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City | OAK BROOK
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State | IL
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Zip | 60522-3307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUNEELA HARSOOR
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Credential | M.D.
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Telephone | 630-229-5701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036-106992
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License Number State | IL
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