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General NPI Number Information
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NPI Number | 1295894319
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Entity Type | Organization
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Legal Business Name | INTEGRATED ORTHOPEDICS, INC.
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 3717 N RAVENSWOOD AVE SUITE 217
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City | CHICAGO
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State | IL
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Zip | 60613-3880
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Country | US
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Telephone | 773-248-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 3717 N RAVENSWOOD AVE SUITE 217
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City | CHICAGO
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State | IL
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Zip | 60613-3880
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Country | US
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Telephone | 773-248-6400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL WILFORD
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Credential |
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Telephone | 773-744-1578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 69000193A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 203.000143
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License Number State | IL
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