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General NPI Number Information
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NPI Number | 1285953844
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Entity Type | Individual
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Provider Name | JILL MOGIL O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 2821 N BALLAS RD STE C11
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2313
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Country | US
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Telephone | 833-376-6445
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Fax | 314-312-6984
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Provider Business Mailing Address
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Address Line | PO BOX 11805
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City | CLAYTON
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State | MO
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Zip | 63105-0605
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Country | US
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Telephone | 888-376-6445
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Fax | 314-312-6984
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046007879
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TO2571
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | T02571
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License Number State | MO
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