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NPI 1295003507

NPI 1295003507 : ANGELA TIMONES PHARMD : ROSELLE, IL

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General NPI Number Information
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    NPI Number           |    1295003507
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    Entity Type          |    Individual 
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    Provider Name        |    ANGELA TIMONES PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/01/2011
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    Last Update Date     |    12/01/2011
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Provider Practice Location Address
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    Address Line         |    861 CROSS CREEK DR. UNITE 2B
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    City                 |    ROSELLE
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    State                |    IL
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    Zip                  |    60172-3694
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    Country              |    US
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    Telephone            |    847-414-1506
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    861 CROSS CREEK DR N UNIT 2B
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    City                 |    ROSELLE
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    State                |    IL
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    Zip                  |    60172-3694
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    Country              |    US
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    Telephone            |    847-414-1506
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    051.292763
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    License Number State |    IL
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