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General NPI Number Information
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NPI Number | 1295023026
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Entity Type | Organization
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Legal Business Name | FRANK A. VICARI, M.D., LLC
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 1675 W DEMPSTER ST
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City | PARK RIDGE
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State | IL
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Zip | 60068-1110
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Country | US
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Telephone | 847-302-9330
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Fax |
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Provider Business Mailing Address
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Address Line | 777 OAKMONT LN SUITE 1600
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City | WESTMONT
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State | IL
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Zip | 60559-5511
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Country | US
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Telephone | 630-789-2550
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK A. VICARI
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Credential | M.D.
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Telephone | 847-302-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 036068514
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License Number State | IL
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