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NPI 1275832040

NPI 1275832040 : KIRK A SCHUBERT PHARM D : ROCKFORD, IL

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General NPI Number Information
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    NPI Number           |    1275832040
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    Entity Type          |    Individual 
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    Provider Name        |    KIRK A SCHUBERT PHARM D
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/19/2011
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    Last Update Date     |    03/19/2011
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Provider Practice Location Address
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    Address Line         |    1401 E STATE ST EMERGENCY DEPARTMENT
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    City                 |    ROCKFORD
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    State                |    IL
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    Zip                  |    61104-2315
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    Country              |    US
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    Telephone            |    815-543-0591
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14130 BURR OAKS LN 
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    City                 |    STOCKTON
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    State                |    IL
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    Zip                  |    61085-9513
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    Country              |    US
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    Telephone            |    815-541-6850
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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        |    1835P0018X
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    Taxonomy Name        |    Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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    License Number       |    051291111
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    License Number State |    IL
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